Screen time and moderate-to-vigorous physical activity changes and displacement in adolescence: A prospective cohort study

Adolescent smartphone use, sleep, and physical activity: daily associations between sensor-based measures in the adolescent brain cognitive development (ABCD) study

PURPOSE

Potential health consequences of adolescent smartphone use are a growing public concern. Improving upon existing, largely self-report-based research, this study investigated relationships between adolescent smartphone use, sleep, and physical activity using passive sensor measures.

METHODS

Over three weeks, 791 Adolescent Brain Cognitive Development (ABCD) Study participants (Mage=14.12, 53 % female) provided smartphone application and keyboard use data via the Effortless Assessment Research System (EARS) application, and sleep and physical activity data via Fitbit device.

RESULTS

Mixed-effects models found that daytime/evening application use (6:00AM-7:59PM) predicted reduced exercise, more time sedentary, and fewer daily steps (Standardized β=-0.21-0.07, P<.001). Late-evening use (8:00PM-9:59PM) modestly predicted increased sedentary time and reduced steps (Standardized β=-0.05-0.02, P<.001). Late-night use (10:00PM-5:59AM) predicted reduced sleep, delayed sleep onset, delayed waking, increased sedentary time, and fewer daily steps (Standardized β=-0.16-0.27, P<.001). After disaggregating within and between-person smartphone use, within-person relationships remained significant, with associations of similar magnitude to the initial analyses (daytime/evening use: standardized ꞵ=-0.22-0.07, P<.001; late-evening use: standardized ꞵ=-0.05-0.02, P<.001; late-night use: standardized ꞵ=-0.16-0.24, P≤.002), indicating daily-level relationships unattributable to between-subject differences. Examining smartphone use effects by hour relative to sleep onset indicated that only use recorded after initial sleep onset significantly predicted sleep, while use recorded 3-12 hours before sleep onset significantly predicted step counts.

CONCLUSIONS

Using passive sensor data, we found significant associations between adolescent smartphone use, physical activity, and sleep which differed by time of day and remained significant within subjects. Experimental replication is recommended to strengthen tentative causal claims.

Adolescents' screen-based media use and the relationship with moderate-to-vigorous physical activity, sports club participation and active commuting

AIM

A worry regarding young people's physical activity engagement relates to a potentially competing development: the role of screen-based media (SBM) in their everyday lives. The present study aimed to assess time spent on different types of SBM, self-reported moderate-to-vigorous physical activity (MVPA) and physical activity in different domains and their interrelations.

METHODS

The study is based on data from 3737 participants aged 11, 13 and 15 years from Norway collected in 2021/2022 as part of the Health Behaviour in School-aged Children collaborative cross-national survey.

RESULTS

The findings revealed high amounts of total SBM time. There were age and gender differences in physical activity, especially with lower levels of active transport during leisure time among girls than among boys. A series of binary logistic regression analyses with adjustment for age, gender and socioeconomic status showed that high levels of total SBM time were negatively associated with involvement in club sports, active school transport, active travel to friends and leisure activities, and 60 min MVPA 5 days/week. Gaming and social media use were also negatively associated with most of the physical activity indicators. All SBM variables were negatively associated with involvement in club sports and 60 min MVPA 5 days/week.

CONCLUSIONS

The study demonstrates negative associations between SBM time among adolescents and physical activity in various domains. Actions to facilitate youth physical activity in the digital age seem crucial. Additional studies with nuanced data on these behaviours and longitudinal research design allowing for examining their interrelations over time are needed.

School Factors Associated With Physical Activity Participation in Children and Adolescents With Disabilities: A Systematic Review

This systematic review synthesizes quantitative evidence on school factors associated with physical activity (PA) participation in children and adolescents with disabilities (CAD). A comprehensive search was conducted in four databases, and studies were included if they quantitatively measured PA levels and examined school factors associated with PA participation among CAD. Methodological quality was assessed, and a semiquantitative synthesis was performed. Twenty-four studies with good to excellent methodological quality were included. Five primary and 21 secondary school factors linked to PA engagement in CAD were identified: school time structure, school PA characteristics, school physical environment, school social environment, and school organizational factors. Among these, four factors of the school time structure (i.e., physical education time, recess time, lunch time, and before- and/or after-school time) showed the most consistent positive associations with PA. This review highlights the critical role of structured school time for school-based PA promotion in CAD.

Exploring digital use, happiness, and loneliness in Japan with the experience sampling method

Smartphones have become an integral part of modern life, raising concerns about their impact on mental health, especially among young people. However, previous studies yielded inconsistent results, possibly due to neglecting the possibility of interactions between offline and online communications. To explore potential interactions among different communication modes (online vs. offline) and communication types (private vs. public), we adopted the experience sampling method to track 418 Japanese individuals over 21 days and analyzed the data using multilevel models and psychometric network models. The findings revealed that digital use has only small direct effects on happiness and loneliness, especially through public (one-to-many) online communication. The increased digital use reduced offline communication time, indirectly influencing loneliness to a large degree. Overall, this study highlights the indirect effects of decreased face-to-face communication and the significant role of one-to-many online communication, which may explain a part of the diverse findings on this issue.

Prospective evaluation of 24-hour movement behaviors among adolescents recovering from a sport-related concussion

This study aimed to describe the 24-hour composition of movement behaviors, including sleep, sedentary behavior, and physical activity (PA), among pediatric sports-related concussion (SRC) patients over their recovery period, assess the association between movement compositions and recovery time, and understand feasibility of 24-hour accelerometry in the study population. A cohort of 50 pediatric SRC patients were asked to wear a wrist-worn accelerometer continuously for the duration of their recovery. Among all enrolled participants, the sample was primarily 14 or 15 years of age (65%), female (55%), and recovered in under 28 days (88%). Accelerometer compliance was moderate; 35 participants (70%) were compliant with the protocol. Compositional analysis was used to address time-use objectives in 33 participants who provided adequate data for inclusion. Overall, participants spent an average of 50% of their 24-hour day sedentary, 33% sleeping, 11% in light intensity PA, and 6% in moderate or vigorous intensity PA. The 24-hour composition of movement behaviors was not associated with recovery time (p = .09-.99). However, the limited sample size may have contributed to null findings. Given recent evidence supporting the effects of sedentary behavior and PA on concussion recovery, future studies should aim to further validate these findings in a larger sample.

Physical activity, problematic gaming behavior, and quality of life prior and during the first 9 months of the COVID-19 pandemic: Findings from a longitudinal study among university students

BACKGROUND

Generally, there is limited information on longitudinal trends and the interrelations between physical activity (PA), problematic gaming behavior (PGB), described as a dysfunctional pattern of videogame activities, and quality of life (QoL) based on data that include measurements from both pre- and postpandemic onset. This is also the case for university students. As society faced unprecedented restrictions during this period, these aspects may have developed unfavorably.

OBJECTIVE

To examine PA, PGB, and QoL among Norwegian University students prior to and during the initial stages of the pandemic and assess their temporal interrelations.

METHOD

The data are derived from the "Students' Psychological Health Over Time" study (SPOT). Linear mixed models were used to examine the development from January 2020 to November 2020 over three time points for the total sample and across gender. A traditional cross-lagged panel model analysis was used to estimate temporal associations. Age, gender, socioeconomic status, and partner status were included as covariates.

FINDINGS

PA and QoL decreased linearly over time (Cohen's d = 0.12 and 0.35, respectively), while only male students reported a small reduction in PGB (Cohen's d = 0.03). PA levels decreased considerably more for male students than female students (Cohen's d = 0.17 and 0.09, respectively). There was a small reciprocal negative temporal association between PA and PGB (standardized β = -0.04 and -0.05, respectively). All other temporal associations were not statistically significant in the adjusted analysis.

CONCLUSION

The findings highlight gender-variant negative developments in PA and QoL and suggest a negative reciprocal interrelation between PA and PGB. The findings point to potential adverse health effects that should be taken into account when restrictive pandemic measures are considered.

Internet addiction and health-related quality of life in adolescents: The mediating role of sleep disturbance

BACKGROUND

Internet addiction (IA) has emerged as a recognized risk factor associated with impaired health-related quality of life (HRQOL) in adolescents. However, the role of sleep disturbance in this association remains unclear. This study aimed to investigate the association of IA with HRQOL in Chinese adolescents and to evaluate the potential mediating role of sleep disturbance.

METHODS

A cross-sectional study was conducted among adolescents attending six randomly selected middle schools in Guangzhou, China. Adolescents self-reported their internet use using the Young Diagnostic Questionnaire. HRQOL and sleep disturbance were assessed by the Pediatric Quality of Life Inventory version 4.0 and the Pittsburgh Sleep Quality Index, respectively. Multivariate linear regression analysis was employed to assess the association between IA and HRQOL. Baron and Kenny's causal steps method was used to examine the possible mediating role of sleep disturbance.

RESULTS

Of the 6473 adolescents included, 23.5% had maladaptive internet use (MIU) and 16.6% had pathological internet use (PIU). Compared to adolescents with adaptive internet use (AIU), those with IA had significantly lower scores across all HRQOL dimensions and summary scales. Mediation analysis revealed that sleep disturbance was a significant mediator. Specifically, sleep disturbance mediated 34.55% of the effects of MIU and 34.06% of the effects of PIU on the HRQOL total scale score , respectively.

CONCLUSIONS

IA was associated with poorer HRQOL, indicating the needs of preventing IA in Chinese adolescents. Additionally, our findings underscored the importance of enhancing sleep quality to mitigate the adverse impact of IA on adolescents' well-being.

Autonomous motivation, social support, and physical activity in school children: moderating effects of school-based rope skipping sports participation

Purpose

Recent studies have shown that physical activity (PA) levels are low among children and adolescents globally. In order to reverse this trend, PA interventions are increasingly favoured. The school setting is the ideal place to address the issues that many children face. The purpose of this study was to (a) The primary focus of this study is to delve into the mediating role played by school-based rope skipping sports participation (SRSP) in the connection between social support and moderate to high-intensity physical activity (MVPA) among school children. (b) Additionally, this research aims to examine the moderating effect of within this pathway.

Methods

We conducted a survey involving 721 adolescents residing in Changsha City. The participants' ages ranged from 8 to 12 years, with an average age of 9.84 ± 1.535 years. Out of these participants, 406 were boys, and 315 were girls. To assess variables such as social support and autonomous motivation, we employed standardized measurement scales. Subsequently, we analyzed the collected data using various statistical methods, including independent s-amples t-tests, bivariate correlation analysis, descriptive statistical analysis, structural equation modeling (SEM), and the Johnson-Neyman method.

Results

An independent samples t-test revealed a statistically significant difference in MVPA between genders (p = 0.003 < 0.05), with boys exhibiting a higher level of engagement in MVPA compared to girls, Correlation analysis revealed significant positive associations among several key variables. Specifically, social support demonstrated a noteworthy positive correlation with autonomous motivation (r = 0.331, p < 0.01) as well as school children's engagement in MVPA (r = 0.308, p < 0.01). Moreover, autonomous motivation displayed a significant positive correlation with school children's involvement in MVPA (r = 0.459, p < 0.01). The moderating analysis revealed a significant influence of the interaction between increased participation in and social support on school children's engagement in MVPA.

Conclusion

Social support and autonomy support have been proven effective in enhancing school children's engagement in MVPA. They exert their influence indirectly by fostering autonomous motivation. Notably, robust social support can significantly benefit MVPA school children with high activity requirements, particularly those regularly engaged in MVPA during the school day.

Importance of training volume through the use of step trackers apps promoted from the subject of physical education to change body composition, physical fitness and physical activity in adolescents and the influence of gender✰,✰✰

The aim of the present study was to determine the changes in physical activity level (PA), kinanthropometric and derived variables, and physical fitness in adolescents, as a result of an out-of-school intervention with mobile step tracker apps promoted from the field of physical education, according to the volume of training completed and gender. A randomized controlled trial was carried out with 400 adolescents (210 males and 190 females) aged 12 to 16 years old (mean age: 13.96 ± 1.21 years-old). Adolescents were divided into experimental group (EG) (n = 240) and control group (CG) (n = 160). Two measurements were carried out, separated by a 10-week intervention, and PA, kinanthropometric variables and physical condition were measured. During the intervention, EG must use Strava (n = 74); Pokémon Go (n = 59); Pacer (n = 60); and MapMyWalk (n = 47) a minimum of 3 times per week, covering an incremental distance from 7,000 steps per day (week 1) to 12,500 steps per day (week 10). After that, EG were divided in quartile according to the volume of training completed. The results obtained showed a significant increase between pre-and post in PA (p = 0.009-0.044) and curl-up (p < 0.001-0.040) in EG regardless the quartile of compliance, and a reduction in fat variables (p < 0.001) and an increase in CMJ in 75-100 % compliance group (p = 0.005). The introduction of the covariate gender did not introduce changes in the intra-group evolution. On inter-group differences, differences were only found for the post-test values between 0-25 % Vs 25-50 % and between 50-75 % Vs 75-100 % with the group that completed a longer distance being the one that showed the lowest values in the post-test in both cases. When including the covariate gender, no significant differences were found for either the pre-test or the post-test on either variable. To conclude, a higher training volume with mobile apps seems to be relevant in the increase PA and strength and decrease of fat mass. The gender factor is not influential in the intra-group changes, but it is influential in the inter-group differences.

Screen media activity in youth: A critical review of mental health and neuroscience findings

This review has two primary objectives: (1) to offer a balanced examination of recent findings on the relationship between screen media activity (SMA) in young individuals and outcomes such as sleep patterns, mood disturbances, anxiety-related concerns, and cognitive processes; and (2) to introduce a novel multi-level system model that integrates these findings, resolves contradictions in the literature, and guides future studies in examining key covariates affecting the SMA-mental health relationship. Key findings include: (1) Several meta-analyses reveal a significant association between SMA and mental health issues, particularly anxiety and depression, including specific negative effects linked to prolonged screen time; (2) substantial evidence indicates that SMA has both immediate and long-term impacts on sleep duration and quality; (3) the relationship between SMA and cognitive functioning is complex, with mixed findings showing both positive and negative associations; and (4) the multifaceted relationship between SMA and various aspects of adolescent life is influenced by a wide range of environmental and contextual factors. SMA in youth is best understood within a complex system encompassing individual, caregiver, school, peer, and environmental factors, as framed by Bronfenbrenner's ecological systems theory, which identifies five interrelated systems (microsystem, mesosystem, exosystem, macrosystem, and chronosystem) that influence development across both proximal and distal levels of the environment. This model provides a framework for future research to examine these interactions, considering moderating factors, and to develop targeted interventions that can mitigate potential adverse effects of SMA on mental well-being.

Displacement of peer play by screen time: associations with toddler development

BACKGROUND

Young children's digital media use may adversely affect child development, but the mechanisms of this association are unclear. We evaluated whether screen time displaces reading and peer play time, which are subsequently associated with child development.

METHODS

When children were 12, 18, 24, 30, and 36 months, mothers (n = 3894) reported the time their children spent on screens, being read to by an adult, and playing with other children. At 36 months, mothers completed the Ages and Stages Questionnaire©, an assessment of their child's developmental status.

RESULTS

In unadjusted models, screen time from 12 to 36 months was not associated with reading but was associated with less time engaging in play with peers. In adjusted models accounting for developmental delay at 12 months, family and child characteristics, screen time was not directly associated with developmental delay. More peer play time was associated with a lower likelihood of developmental delay, and having higher screen time increased the likelihood of developmental delay indirectly through reduced peer play time. Results were similar for developmental delays in fine and gross motor, communication, and personal-social domains.

CONCLUSIONS

Screen time in early childhood did not displace reported time spent reading, but did displace reported peer play time.

IMPACT

Among children 1-3 years of age, more screen time was associated with less time engaged in peer play but not less reading with an adult. Having higher screen time from 1 to 3 years increased the odds of developmental delay indirectly through reduced peer play time. Ensuring that children engage in adequate time playing with peers may offset the negative associations between screen time and child development.

Moderate-Vigorous Physical Activity, Screen Time and Sleep Time Profiles: A Cluster Analysis in Spanish Adolescents

The study had two aims: (1) To classify the adolescents according to their levels of moderate-vigorous physical activity, screen time and sleep time, and (2) to analyze, in a descriptive and correlational manner, the profiles of moderate-vigorous physical activity, screen time and sleep time of each cluster according to the sex and grade of the adolescents. The study design was cross-sectional, with descriptive and correlational analysis. The sample consisted of 663 adolescents in Compulsory Secondary Education from Soria (Spain). The Four by One-Day Physical Activity Questionnaire was used to measure levels of physical activity, screen time and sleep time. The results showed that the young people had an average of 67.99 ± min/day of moderate-vigorous physical activity, 112.56 min/day of screen time and 548.63 min/day of sleep time. Adolescents were classified into three clusters according to their levels of physical activity, screen time and sleep time (F_MANOVA (6,1318) = 314.439; p ≤ 0.001; β = 1; f = 1.177). In conclusion, only 28.21% of the young people accomplished the recommendations for physical activity practice, screen time and sleep time. Moreover, these results vary according to the sex and grade of the adolescents.

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

BACKGROUND

Both excessive screen time and early screen exposure have been linked to children's health outcomes, but few studies considered these two exposures simultaneously. The aim of this study was to explore the independent and interactive associations of excessive screen time and early screen exposure with health-related quality of life (HRQOL) and behavioral problems among Chinese children attending preschools.

METHODS

A cross-sectional study of 4985 children aged between 3 and 6 years was conducted in Chengdu, China. Each parent has finished an online questionnaire regarding their children's screen use, HRQOL, and behavioral problems. Children with screen time over 1 h/day were considered as having excessive screen time. Early screen exposure was defined if the children had started using screen-based media before the age of 2 years. HRQOL was assessed by the Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0), while behavioral problems were confirmed with the 48-item Conners' Parent Rating Scale (CPRS-48).

RESULTS

Of the 4985 children (2593 boys and 2392 girls) included, the mean age was 4.6 (SD: 1.0) years. After adjustment for confounders and early screen exposure, excessive screen time was significantly associated with worse HRQOL scores in all dimensions and summary scales, as well as each type of behavioral problems (all p values < 0.05). We also found that compared to children with later initiation of screen exposure, those with screen use before the age of 2 years had significantly lower emotional functioning score (β: - 2.13, 95%CI: - 3.17, - 1.09) and psychosocial health summary score (β: - 0.82, 95%CI: - 1.54, - 0.10) of HRQOL, as well as higher risks of conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, and hyperactivity index, which were independent of excessive screen use. Furthermore, there were significant interactive effects of excessive screen time and early screen exposure on emotional functioning domain of HRQOL scores and conduct problems.

CONCLUSION

Excessive screen time and early screen exposure are two independent and interactive factors to children's HRQOL and behavioral problems. Our findings support current guidelines to limit screen exposure in children. Appropriate screen use may represent an important intervention target to improve children's HRQOL and reduce their behavioral problems.

Associations between digital gaming behavior and physical activity among Finnish vocational students

Abstract

Digital gaming is considered to be a major sedentary lifestyle among youth. The time spent on digital gaming may also affect the physical behavior of young adults.

Objective

This study aimed to investigate the associations between various characteristics of digital gaming behavior (i.e., gaming time, device, and game type) and participation in physical activity among Finnish vocational students.

Materials and methods

The research employed a cross-sectional survey design. The analyzed sample consisted of 773 students (455 males, 318 females) from eight vocational school units in Northern Finland who regularly played digital games. Data were collected via an online self-reported questionnaire, which included questions concerning average weekly time spent on digital gaming, preferred device, favorite types of games, and physical activity.

Results

The students spent an average of two hours each day playing digital games. Males preferred to play using personal computers (PCs), whereas mobile gaming was more popular among females. Shooter (42.4%) and entertainment (64.2%) games were the most popular game types among males and females, respectively. The results revealed that male gender and PC gaming were both positively related to physical inactivity among vocational school students. A preference toward sport games was inversely related with physical inactivity.

Conclusion

The presented findings can be utilized to develop interventions that target the prevention of sedentary behavior among vocational students. Further longitudinal studies will be required to reliably assess the relationship between digital gaming and physical activity.

Moderate-Vigorous Physical Activity, Family Support, Peer Support, and Screen Time: An Explanatory Model

It is important to investigate how the different factors of physical activity and screen time influence each population group in order to design effective proposals for health promotion. This study aims to: (1) create an explanatory model to establish the relationships between moderate-vigorous physical activity time, screen time, family support, and peer support of adolescents in the region of Soria (Spain); (2) contrast the explanatory structural model according to the intensity of physical activity. A representative sample of 694 adolescents, aged 12-17 years, from the region of Soria was selected. The Four by One-Day Physical Activity Questionnaire, the Parent Support Scale, and the Peer Support Scale were administered. The data were treated according to a structural equation model to demonstrate the relationships between the study variables. The Chi-square p-values and standardised fit indices (CFI, NFI, IFI, TLI, and RMSEA) were appropriate. Moreover, acceptable parameters were obtained in the general equations. The theoretical model is useful to explain the relationships between moderate-vigorous physical activity, family support, peer support, and screen time. In addition, models that differentiate between moderate and vigorous physical activity independently are also useful. Peer support plays a particular role relative to physical activity time, and family support plays a specific role regarding screen time.

The Relationships between Physical Activity, Screen Time and Sleep Time According to the Adolescents' Sex and the Day of the Week

This study had two aims: (1) to identify the levels of physical activity, screen time and sleep time of adolescents according to the sex of the participant and the day of the week; (2) to find out the relationships between physical activity, screen time and sleep time according to the sex of the participant and the day of the week. The study design was non-experimental, descriptive-correlational and cross-sectional. The sample consisted of 694 adolescents in Compulsory Secondary Education from Soria (Spain). Four by One-Day Physical Activity Questionnaires were used to measure levels of physical activity, screen time and sleep time. Levene’s test and Student’s t-test were used to calculate the difference between the means of the variables. Pearson’s test was used to calculate bivariate correlations between variables. Results showed higher levels of screen time in males (136.93 min/day ± 81.548). Screen time, sleep time and moderate−vigorous physical activity are higher during the weekend. Positive relationships were found between screen time and light physical activity (rmales = 0.274; p ≤ 0.01; rfemales = 0.065; p > 0.05). The correlations between moderate−vigorous physical activity and screen time were negative (rmales = −0.282; p ≤ 0.01; rfemales = −0.187; p ≤ 0.05). The relationship between screen time and sleep time was negative in males (r = −0.135; p ≤ 0.05). In conclusion, the levels of physical activity, screen time and sleep time vary according to the sex of the participants and the day of the week.

Physical Activity, Energy Expenditure, Screen Time and Social Support in Spanish Adolescents-Towards an Explanatory Model about Health Risk Factors

Youth obesity has been a pandemic for decades. One of its causes is a low level of physical activity. It is necessary to know the specific situation of adolescents and the factors that influence it in order to be able to act accordingly. The first aim of the current study is to create an explanatory model to establish the relationships between light physical activity time, light physical activity energy expenditure, screen time and social support. The second aim is to propose a theoretical model specifying the relationships between moderate-vigorous physical activity time, moderate-vigorous physical activity energy expenditure, screen time and social support. The study design was non-experimental (ex post facto), descriptive-correlational and cross-sectional. A total of 694 adolescents from the region of Soria (12-17 years) participated in the study. The instruments administered were the Four by One-Day Physical Activity Questionnaire, Parent Support Scale and Peer Support Scale. Two structural equation models were developed to analyse the relationships between the variables that comprised the explanatory models. The results show that social support had a negative influence on screen time in the proposed model in relation to light physical activity (r = -0.210; p ≤ 0.001) and in the proposed one regarding moderate-vigorous physical activity (r = -0.173; p ≤ 0.05). Social support was negatively related to light physical activity time (r = -0.167; p ≤ 0.05). Family support had a greater influence than did peer support. In conclusion, the models for light and moderate-vigorous physical activity are useful to describe the relationships between time, energy expenditure, screen time and social support.

An Explanatory Model of the Relationships between Physical Activity, Social Support and Screen Time among Adolescents

Effective physical activity studies are necessary to understand how factors involved in physical activity mediate behaviour. Therefore, more reliable explanatory models can be generated in order to design effective actions to promote physical activity. The study had two aims: (1) to develop an explanatory model to identify and establish the relationships between physical activity, social support and screen time among adolescents; and (2) to contrast the explanatory structural model by means of a multi-group analysis according to sex. The study design was cross-sectional with descriptive and correlational analysis. The research was carried out with a representative sample of adolescents from the province of Soria (mean age 14.06 ± 1.27 years). The instruments used were: Four by One-Day Physical Activity Questionnaire, Parent Support Scale and Peer Support Scale. The results show that social support had a negative relationship with screen time (r = −0.178; p ≤ 0.001); males had a positive relationship between physical activity and screen time (r = 0.118; p ≤ 0.05); and peer support had more influence on social support than parental support. In conclusion, the proposed model was effective in triangulating the relationships between physical activity, social support and screen time in a novel way, while allowing us to discriminate these results according to participants’ sex.

Barriers to high school and university students' physical activity: A systematic review

Physical inactivity commonly occurs throughout one's life, particularly during adolescence and young adulthood. Multiple factors can negatively influence participation in physical activity, but there has been no review examining the barriers to physical activity among high school and university students. Therefore, the aim of this systematic review was to summarize evidence of barriers to the practice of physical activity among high school and university students. The literature search was conducted without time limits using five databases, including CINAHL, Cochrane Library, Embase, PubMed, and Scopus. In total, 59 studies (37 with high school students [n = 22,908] and 22 with university students [n = 15,411]) were included. The main barriers identified in high school and university students were lack of time, lack of motivation, and lack of accessible places. These findings may be useful in designing and implementing evidence-informed interventions and programs for physical activity promotion in students.

Family-focused contextual factors associated with lifestyle patterns in young children from two mother-offspring cohorts: GUSTO and EDEN

BACKGROUND

Integrated patterns of energy balance-related behaviours of preschool children in Asia are sparse, with few comparative analyses.

PURPOSE

Using cohorts in Singapore (GUSTO) and France (EDEN), we characterized lifestyle patterns of children and investigated their associations with family-focused contextual factors.

METHODS

Ten behavioural variables related to child's diet, walking, outdoor play and screen time were ascertained by parental questionnaires at age 5-6 years. Using principal component analysis, sex-specific lifestyle patterns were derived independently for 630 GUSTO and 989 EDEN children. Contextual variables were organised into distal (family socio-economics, demographics), intermediate (parental health, lifestyle habits) and proximal (parent-child interaction factors) levels of influence and analysed with hierarchical linear regression.

RESULTS

Three broadly similar lifestyle patterns were identified in both cohorts: "discretionary consumption and high screen time", "fruit, vegetables, and low screen time" and "high outdoor playtime and walking". The latter two patterns showed small differences between cohorts and sexes. The "discretionary consumption and high screen time" pattern was consistently similar in both cohorts; distal associated factors were lower maternal education (EDEN boys), no younger siblings (GUSTO boys) and Malay/Indian ethnicity (GUSTO), while intermediate and proximal associated factors in both cohorts and sexes were poor maternal diets during pregnancy, parents allowing high child control over food intake, snacking between meals and having television on while eating.

CONCLUSIONS

Three similar lifestyle patterns were observed among preschool children in Singapore and France. There were more common associated proximal factors than distal ones. Cohort specific family-focused contextual factors likely reflect differences in social and cultural settings. Findings will aid development of strategies to improve child health.

Increased Gaming During COVID-19 Predicts Physical Inactivity Among Youth in Norway-A Two-Wave Longitudinal Cohort Study

Background

A concern for the COVID-19 measures and the potential long-term consequences the measures may have on physical inactivity and gaming among youth.

Objectives

Examine the stability and change in internet and offline gaming and the association with physical inactivity among adolescents in Norway during the pandemic.

Methods

A total of 2940 youth (58% girls) aged 12-19 years participated in an online longitudinal two-wave survey during the first Norwegian national lockdown in April 2020 (t1) and in December 2020 (t2). Gaming behavior and physical activity status were assessed at both time points. Age, gender, and socioeconomic status were included as covariates.

Results

Among boys, 41% reported gaming a lot more and 35% a little more at t1 compared to before the national lockdown. The corresponding numbers for girls were 14 and 23%, respectively. In fully adjusted analysis, a pattern of increased gaming at t1 followed by an additional increase in gaming reported at t2 was associated with physical inactivity at t1 (OR = 2.10, p < 0.01) and t2 (OR = 2.45, p < 0.001). Participants gaming more at t1 followed by a reduction at t2 had higher odds of inactivity at t1 (OR = 1.88, p < 0.01). Youth reporting no gaming at t1 had lower odds for inactivity at this time point (OR = 0.67, p < 0.05).

Conclusions

Increased gaming among many youths and a relationship with physical inactivity was observed during the first phase of the COVID-19 pandemic. To counteract the negative long-term impacts of COVID-19 restrictions, public health initiatives should emphasize the facilitation of physical activity in youth and develop effective strategies to prevent problematic gaming.

Association between Leisure Screen Time and Emotional and Behavioral Problems in Spanish Children

OBJECTIVE

To assess the relation between leisure screen time and emotional and behavioral problems in Spanish children aged 4-14 years.

STUDY DESIGN

This cross-sectional study used a representative sample of children aged 4-14 years included in the 2017 Spanish National Health Survey (n = 4073). Emotional and behavioral problems of children were assessed through the parent-report Strengths and Difficulties Questionnaire. Daily leisure screen time in minutes was categorized as 0-59, 60-119, 120-179, and ≥180. We calculated adjusted prevalence ratios (aPR) and their 95% CIs of being at risk of developing emotional and behavioral problems. Associations were adjusted for potential confounding variables.

RESULTS

Children spending 180 minutes or more of daily leisure screen time compared with children spending less than 1 hour were more likely to be at risk of developing emotional and behavioral problems: aPR_≥180: 2.19 (95% CI 1.53-3.14), emotional symptomology: aPR_≥180: 2.09 (95% CI 1.37-3.18), conduct problems aPR_≥180: 1.85 (95% CI 1.34-2.54), peer problems aPR_≥180: 1.78 (95% CI 1.15-2.75), and to behave less prosocially: aPR_≥180: 2.20 (95% CI 1.43-3.37).

CONCLUSIONS

We have found significant associations between daily leisure screen time and emotional and behavioral problems in Spanish children between 6 and 14 years of age. However, these findings should be confirmed in cohort studies, so institutions might consider including screen time as a new risk factor for children.

Screen time reduction and focus on social engagement in autism spectrum disorder: A pilot study

BACKGROUND

There is growing concern regarding early screen media exposure and its potential effects on developmental delays including autism spectrum disorder (ASD). However, there is little research examining whether interventions can decrease screen media exposure and ASD behaviors among children with ASD.

METHODS

Participants were nine children, 18 to 40 months old, with an ASD diagnosis who watched screens at least 2 h per day. Screen viewing history and weekly screen viewing and social interaction were assessed. The intervention involved a parent education program followed by weekly 1 h in-home support visits aimed at replacing screen time with social engagement time over a 6 month period. Child autism symptoms (Brief Observation of Social Communication Change), functional behavior (Vineland Adaptive Behavior Scales), and development (Mullen Scales of Early Learning) were assessed before and after intervention; parents completed questionnaires on parental stress (Autism Parenting Stress Index) and their perceptions of the intervention.

RESULTS

Children's screen viewing decreased from an average of 5.6 h/day prior to intervention to 5 min/day during the study. Significant improvements were observed in core autism symptoms and parental stress from pre- to post-intervention.

CONCLUSIONS

Parent education and training/support to minimize screen time and increase social interaction for young children with ASD was tolerated well by parents and children. These promising preliminary results suggest that further research on early screen media viewing, ASD, and screen reduction intervention is warranted.

Comparison of Physical Activity and Sedentary Behaviour between Schoolchildren with Cystic Fibrosis and Healthy Controls: A Gender Analysis

The purpose of this study was to examine differences in sports participation and the levels of physical activity (PA) and sedentary behaviour (SB) between schoolchildren with cystic fibrosis (CF) and a healthy control group (CG) taking into account the gender variable. PA and SB were measured with an accelerometer for 7 consecutive days in 44 children (24 girls; 11.0 (3.2) years) with CF and 45 age-, sex-, and socioeconomic status-matched controls (24 girls; 11.1 (3.0) years). CF patients and CG did not differ in moderate-to-vigorous PA (54 (31) vs. 59 (27) min/day respectively) or in SB (558 (106) vs. 553 (92) min/day respectively). There were no differences in meeting the PA guidelines between both groups (CF: 36.4% vs. CG: 42.4%). Gender analysis revealed that boys were more active and met more PA guidelines than girls regardless of the group (CF or CG), girls with CF being the least active group (only 16.7% met PA guidelines). A possible compensatory effect was found between SB and PA only in the CF sample, as for each minute/day spent in SB the odds of meeting PA guidelines decreased by 34%. These findings suggest that promoting a reduction in SB is as important as promoting PA in the CF population, especially in girls. Health caregivers, coaches, teachers, or parents could offer appealing supervised and unsupervised physical activities, foster the adoption of active lifestyles, or incorporate PA into daily routines to improve the health of CF schoolchildren.

Association between Leisure Screen Time and Junk Food Intake in a Nationwide Representative Sample of Spanish Children (1-14 Years): A Cross-Sectional Study

Evidence on the association between new patterns of leisure screen time and junk food consumption in Spanish children at the national level is scarce. The aim of this study is to assess the relation between daily leisure screen time and the frequency of sweet, soft drink, fast food, and snack intake in a representative sample of Spanish children and adolescents aged from 1 to 14 years. We conducted a cross-sectional study using a representative sample of the Spanish population under 15 years recruited for the 2017 Spanish National Health Survey (n = 5480). We dichotomized sweet, soft drink, fast food, and snack intake (high/low) and categorized daily leisure screen time (0–59, 60–119, 120–179, and ≥180 min). We calculated crude prevalence ratios and adjusted prevalence ratios, and their 95% confidence intervals (95% CI), of high frequency of sweet, soft drink, fast food, and snack intake. Children spending at least one hour of daily leisure screen time had higher prevalence of high frequency of sweet and snack intake than children being exposed less than one hour. For soft drinks and fast food, prevalence of high frequency intake was significantly higher from two and three hours of exposure, respectively. Longer periods of screen exposure in Spanish children during their leisure time may be associated with poorer dietary behaviors. The negative effects of excessive screen time in pediatrics population should be further studied.

Determinants of Physical Activity and Screen Time Trajectories in 7th to 9th Grade Adolescents-A Longitudinal Study

Physical activity (PA) in youth tends to decline with increasing age, while sedentary behaviour including screen time (ST) increases. There are adolescents, however, whose PA and ST do not follow this pattern. The aim of this study is (i) to examine trajectories in PA and ST from grade 7-9 among students in Berlin, and (ii) to investigate the relationship of these trajectories with individual factors and school type. For the present analyses, changes in students' PA and ST across three time points from 7th to 9th grade were assessed via self-report questionnaires. Positive and negative trajectories were defined for both PA (positive: increasing or consistently high, negative: decreasing or consistently low) and ST (vice versa). Multivariable logistic regression analyses were performed to identify possible predictors of PA and ST trajectories. In total, 2122 students were included (50.2% girls, mean age 12.5 (standard deviation 0.7) years). Compared to grade 7, less students of grade 9 fulfilled PA and ST recommendations (PA: 9.4% vs. 13.2%; ST: 19.4% vs. 25.0%). The positive PA trajectory included 44% of all students (63% boys), while the positive ST trajectory included 21% of all students (30% boys). Being a boy was significantly associated with a positive PA trajectory, while being a girl, having a high socioeconomic status, and attending a high school, were significantly associated with a positive ST trajectory. Different PA and ST trajectories among adolescents should be taken into account when implementing prevention programs for this target group.