Are mobile phone ownership and age of acquisition associated with child adjustment? A 5-year prospective study among low-income Latinx children

Canadian children and youth with disabilities are not meeting the 24-Hour Movement Guidelines: Cross-sectional results from the national physical activity measurement (NPAM) study for children and youth with disabilities

BACKGROUND

Understanding patterns of movement behaviours for physical activity (PA), screen time (ST) and sleep in children and youth with disabilities (CYD) can identify participation gaps that inform country-specific intervention and policy.

OBJECTIVE

To describe the 24-h movement behaviours and guideline adherence in CYD in Canada. The associations between age, gender, and disability type with meeting movement guidelines were also examined.

METHODS

Cross-sectional caregiver-reported data (N = 524 CYD, Mage = 10.3 ± 3.1 years; 70 % boys; 49 % developmental disabilities) were collected on child PA, ST, and sleep. Items were derived from the Health Behaviour in School-aged Children survey, International Physical Activity Questionnaire-Adolescents and the Childhood Obesity, Lifestyle, and the Environment Diet and Lifestyle Questionnaire. Movement behaviours were described for the total sample and by age, gender, and disability type. Logistic regressions tested predictors of meeting the movement guidelines.

RESULTS

CYD spent 34.2 ± 37.1 min in moderate-to-vigorous PA, 5.3 ± 3.9 h using screens, and 9.9 ± 1.1 h in sleep. 17.2 %, 20.3 %, and 89.0 % met the individual PA, ST, and sleep guidelines; 4.6 % met all three. Youth were less likely to meet the individual ST and sleep guidelines than children (OR = 0.16); participants with multiple disabilities were less likely to meet the ST guideline than those with developmental disabilities (OR = 0.33; ps < 0.001). Age, gender, and disability type did not significantly predict meeting the PA guideline.

CONCLUSION

Most CYD do not meet the Canadian guidelines for PA and ST and the majority meet recommended levels for sleep. Guideline adherence is lower for youth (ST and sleep) and those with multiple disabilities (ST only).

Associations Between Ecological Determinants and Weight Status Changes Among Children from Vulnerable Populations: Empirical Findings from a National Panel Survey in South Korea

BACKGROUND

Pandemic-related weight gain disproportionately has affected children from socioeconomically disadvantaged backgrounds. However, key determinants of childhood obesity among these vulnerable children remain relatively underexplored.

METHODS

In a secondary data analysis using a longitudinal dataset, the relationships between child weight status and its individual and environmental influences among vulnerable children were examined based on an ecological model. We analyzed three-point time-series data for 1308 participants from a Korean national panel survey of vulnerable children. Adiposity estimates were calculated using body mass index (BMI) z-scores.

RESULTS

The panel regression analysis revealed that 2 factors, namely "lack of adequate sleep time" at the individual level and "suboptimal relationships with childcare teachers" at the interpersonal level, had a significant impact on the BMI z-scores of vulnerable children.

CONCLUSIONS

It is crucial to develop strategies that ensure sufficient sleep time and to actively involve childcare centers in implementing place-based interventions and initiatives to prevent obesity among vulnerable children. Moreover, it is essential to continue efforts in identifying the significant determinants of childhood obesity among vulnerable populations by considering the major environments in which these children live and grow.

Combining Ecological Momentary Assessment and Social Network Analysis to Study Youth Physical Activity and Environmental Influences: Protocol for a Mixed Methods Feasibility Study

BACKGROUND

Physical activity (PA) is crucial for youth health, but up to 74% of adolescents fail to meet recommended levels, especially during summer when structured supports associated with school are not available. The social and built environments significantly influence youth PA; yet, their complex interactions remain poorly understood. This study aims to evaluate the feasibility of combining ecological momentary assessment (EMA) and social network analysis to examine bidirectional influences among youth PA, built environments, and social networks during summer.

OBJECTIVE

The objectives are to (1) evaluate the feasibility and acceptability of the combined EMA and Social Network Analysis protocol, and (2) identify phenotypes using person-level, microtemporal, and dynamic overlap between social and built environments.

METHODS

This mixed methods feasibility study with an exploratory observational component will recruit 120 youth aged 12 years to 15 years from an urban school district in Central Texas, US. Participants will first complete a baseline survey to report their general social network patterns and environmental perceptions. Then participants will wear an ActiGraph LEAP accelerometer and respond to EMA prompts via smartphone for 7 days. EMA will assess real-time perceptions of social networks and surrounding built environments, which will be time-matched with accelerometer-assessed PA data. GPS coordinates will be collected with each EMA prompt to assess features of the built environment. Follow-up semistructured interviews will assess protocol acceptability.

RESULTS

This study has been funded by the National Heart, Lung, and Blood Institute. Data collection is expected in the summers of 2025, 2026, and 2027.

CONCLUSIONS

This innovative approach combines EMA, SNA, accelerometry, and GPS data to provide unprecedented insights into the dynamic interplay between social networks, built environments, and youth PA during summer. Findings will inform the development of more targeted, effective interventions to promote PA among youth. While limitations include potential participant burden and generalizability, the study's strengths in capturing real-time, contextualized data make it a valuable contribution to understanding youth PA determinants.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/68667.

Smartphone Ownership, Minors' Well-being, and Parental Mediation Strategies. An Analysis in the Context of Social Media Influencers

Although smartphone ownership among minors has become an important social phenomenon, its impact on children's and adolescents' well-being, as well as the mechanisms by which this might take place are not yet sufficiently well-established. To date, no research has examined the effect of smartphone ownership on the well-being of minors through the consumption of influencer-generated content, nor has it explored the effectiveness of the main prevention strategies employed by parents in this context. To fill those gaps, 800 Spanish minors (50% female) aged from 8 to 16 years old (M = 12.33, SD = 2.38) participated in a correlational study in which the ownership of electronic devices, the consumption of influencer generated content, the parasocial relationship with the influencer, and the most common parental mediation strategies were considered. The results showed a positive association between electronic device ownership and psychological discomfort, problematic usage, and imitation of dangerous behaviors. This association was mediated by the consumption of influencer-generated content and the parasocial relationship established by the minor with the influencer. Regarding preventive strategies, only active mediation was inversely related to poorer well-being indicators, however this positive effect significantly decreased when a smartphone or a similar electronic device was owned by the minor (vs. no owned). These findings contribute to the understanding of how smartphone ownership can affect the well-being of children, emphasizing the need for thoughtful consideration when deciding whether to provide smartphones to minors.

Meeting the Needs of Emerging Adults With Type 1 Diabetes Living in a Rural Area With Mobile Health Interventions: Focus Group Study

BACKGROUND

Emerging adults (EAs; age 18-30 years) with type 1 diabetes (T1D) have more challenges with diabetes management and glycemic control than other age groups. Living in a rural community introduces additional unique diabetes care challenges due to limited access to specialty care and ancillary support services. Yet, few interventions have been developed to improve diabetes management in rural-dwelling EAs with T1D.

OBJECTIVE

This study aimed to understand the diabetes management experiences of older adolescents and EAs (age 16-25 years) with T1D living in a rural area and to assess their perceptions of the acceptability of 4 fully automated mobile health (mHealth) interventions to support diabetes management.

METHODS

EAs were identified by clinical staff through convenience sampling. In total, 8 EAs participated in 1 focus group and 1 EA completed an individual interview; all data were collected over Zoom. Facilitators explored EAs' experiences living in a rural community with T1D and discussed EAs' impressions of, feedback on, and recommendations for improving 4 mHealth interventions to meet the specific needs of EAs with T1D living in rural communities. Discussions were transcribed and analyzed using conventional content analysis.

RESULTS

In total, 9 EAs (aged 18.8, SD 2.7 years; 5, 56% men; 8, 89% White) with a duration of diabetes of 8.6 (SD 4.3) years participated. They described experiences with diabetes stigma (attributing diabetes to poor lifestyle choices) and feelings of self-consciousness (hyperawareness) in their rural communities. They attributed these experiences to the small size of their communities ("everyone knows") and community members' lack of knowledge about diabetes (unable to differentiate between type 1 and type 2 diabetes). In contrast, EAs reported high levels of social support for diabetes and diabetes care from family, friends, and other community members, but low support for medical needs. The location of their diabetes care providers and the limited accessibility of diabetes-specific and general medical care services in their local community created a challenging medical care context. Overall, EAs found mHealth interventions appealing due to their digital delivery and highlighted features that increased accessibility (voiceovers and simple, jargon-free language), individualization (ability to tailor intervention content and delivery), and applicability to their own lives and other EAs with T1D (relatability of vignettes and other content). EAs suggestions for improving the interventions included more opportunities to tailor the interventions to their preferences (greater frequency and duration, ability to adapt content to emerging needs), increasing opportunities for peer support within the interventions (friend and significant other as identified support person, connecting with peers beyond their local community), and making the tone of intervention components more casual and engaging.

CONCLUSIONS

mHealth interventions aligned with EAs' needs and preferences are a promising strategy to support EAs in communities where social support and resources might be limited.

TRIAL REGISTRATION

N/A, not a clinical trial.

Developing the WE BEAT Well-Being Education Programme to foster resilience and build connection in paediatric heart disease

BACKGROUND

The study of psychological well-being and related resilient outcomes is of increasing focus in cardiovascular research. Despite the critical importance of psychological well-being and related resilient outcomes in promoting optimal cardiac health, there have been very few psychological interventions directed towards children with heart disease. This paper describes the development and theoretical framework of the WE BEAT Wellbeing Education Program, a group-based psychoeducation and coping skills training intervention designed to improve psychological well-being and resilience in adolescents with paediatric heart disease.

METHODS

Program development was informed by patient and family needs and input gathered via large, international survey methods as well as qualitative investigation, a theoretical framework, and related resilience intervention research.

RESULTS

An overview of the WE BEAT intervention components and structure of the programme is provided.

CONCLUSIONS

The WE BEAT Wellbeing Education Program was developed as one of the first resiliency-focused interventions in paediatric heart disease with an overall objective to foster positive psychological well-being and resilient outcomes through a health promotion and prevention lens in an accessible format while providing access to safe, peer-to-peer community building. Feasibility pilot results are forthcoming. Future directions include mobile app-based delivery and larger-scale efficacy and implementation trials.

Association between the use of mobile touchscreen devices and the quality of parent-child interaction in preschoolers

The early use of mobile touchscreen devices (MTSDs), including smartphones and tablets, may reduce the frequency and quality of social interactions between children and parents, which could impact their relationship and have negative consequences on children's socio-cognitive development. In this study, we applied a parental questionnaire and a behavioral observational method in a laboratory setting (free and structured play sessions) to examine the association between preschool MTSD use and the quantity and quality of parent-child relationships. Our findings revealed that preschoolers who regularly use MTSDs (n = 47, aged 4-7 years, engaging in MTSD use for at least 2 h per week) are spending less time with their parents and exhibited lower quality interactions compared to non-users (n = 25). However, shared offline leisure time with parents serves as a protective factor among MTSD-users. Furthermore, our study demonstrated a positive association between parents' and children's media use. The results suggest that preschool MTSD use may have unfavorable effects on parent-child interactions, both in terms of quantity and quality. Alternatively, lower quantity and quality of parent-child interaction may lead to higher MTSD use in the child. Based on the results, the importance of engaging in sufficient offline family interactions besides digital media use should be emphasized to parents of preschoolers, and health organizations and governments should include this in their recommendations and policies concerning childhood digital media use.

Impact of social media "challenges" on poison center case volume for intentional ingestions among school-aged children: an observational study

INTRODUCTION

Mental health problems among youth have escalated over the past decade, with increased rates of self-harm, including suicide attempts by ingestion. Social media use has been linked to youth mental health, including "challenges" urging youth to ingest substances for recreational and other purposes. We hypothesized that social media challenges for particular substances would temporally correspond with increased ingestions of these substances.

METHODS

We identified peak Google Trends search times for social media ingestion challenges involving diphenhydramine, laundry pods, nutmeg, and cinnamon, and used data from America's Poison Centers National Poison Data System to plot reported ingestions 3 months before and after peak searches in school-aged children.

RESULTS

There were 2,169 individuals in the analysis. Diphenhydramine was the most frequently reported ingestion for misuse/abuse and suicidal purposes (n = 266 and 1,609, respectively). For all ingestions together, 45 percent (n = 979) had a moderate health effect, and 6.35 percent (n = 137) had a major health effect. Time of peak searches corresponded with increased ingestions for each substance.

DISCUSSION

We found a temporal relationship between peak Google Trends searches for ingestion challenges and ingestions of that substance reported to United States poison centers. Compared to misuse/abuse ingestions, most suicidal ingestions peaked 1-2 months later, suggesting a public health opportunity for intervention.

LIMITATIONS

This retrospective observational study does not establish causal effect. All data are a result of self-reporting of the exposures, which may lead to a reporting bias. Google Trends is not the only search engine and likely underestimates the true incidence of social media posts.

CONCLUSIONS

Additional research is needed on the relationship between social media and youth mental health, particularly around "challenges" that place youths' health at risk. There may be opportunities for intervention to decrease medical and mental health sequelae of these challenges.

Earlier smartphone acquisition negatively impacts language proficiency, but only for heavy media users. Results from a longitudinal quasi-experimental study

There is a growing debate about the proper age at which teens should be given permission to own a personal smartphone. While experts in different disciplines provide parents and educators with conflicting guidelines, the age of first smartphone acquisition is constantly decreasing and there is still limited evidence on the impact of anticipating the age of access on learning outcomes. Drawing on two-wave longitudinal data collected on a sample of 1672 students in 2013 (at grade 5) and 2016 (at grade 8), this study evaluates whether obtaining the first personal smartphone at 10 or 11 years old, during the transition to lower secondary school (early owning), affected their language proficiency trends compared to receiving it from the age of 12 onwards (late owning). Results indicate an overall null effect of smartphone early owning on adolescents' language proficiency trajectories, while a negative effect is found on those who were already heavy screen media users before receiving the device.

Increasing digital mental health reach and uptake via youth partnerships

Youth in the United States are facing an unprecedented mental health crisis. Yet, brick-and-mortar mental healthcare, such as face-to-face therapy, is overwhelmingly inaccessible to youth despite research advances in youth mental health. Digital Mental Health tools (DMH), the use of technologies to deliver mental health assessments and interventions, may help to increase mental healthcare accessibility. However, for a variety of reasons, evidence-based DMH have not been successful in reaching youth in real-world settings, particularly those who are most encumbered with access barriers to mental healthcare. This Comment therefore focuses on increasing DMH reach and uptake by young people, particularly among minoritized youth, by engaging in community-based youth partnerships. This idea recognizes and grows from decades' worth of community-based participatory research and youth partnerships successfully conducted by other disciplines (e.g., social work, public health, urban planning, education). Increasing uptake and engagement is an issue that is unlikely to be solved by adult-driven theory and design. As such, we emphasize the necessity of reframing youth input into DMH design and deployment from one-time participants to integral community-based partners. Indeed, recognizing and valuing their expertise to equitably address DMH implementation challenges, youth should help to pose the very questions that they will help to answer throughout the design and implementation planning for DMH moving forward.