The relationship between media use and psychological and physical assets among third- to fifth-grade girls

The impact of different types of screen time on school-aged children’s quality of life and participation

Introduction

This study investigated the impact of different types of screen time on quality of life and participation in school-aged children.

Method

Twenty-nine typically developing children (mean age: 9.34 [Formula: see text] 1.37, range: 8–14 years) and 20 of their parents completed the Children Screen Time Use Report, the KIDSCREEN-52 and the Participation and Environment Measure for Children and Youth. Spearman rho correlations and linear regressions with bootstrapping were used to assess associations between screen time, health-related quality of life and activity participation.

Results

Regression analysis identified that passive screen time was a significant predictor of various KIDSCREEN-52 domains: physical wellbeing ( b = −0.445, SE B = 0.008, p = .016), autonomy ( b = −0.445, SE B = 0.011, p = .016) and social acceptance ( b = 0.447, SE B = 0.007, p = .048). Educational, social and passive screen time were positively correlated with increased participation in home, community and school activities, respectively.

Conclusion

Findings suggest that passive screen time was mostly predictive of lower quality of life levels. However, passive, educational and social screen time positively correlate with participation in typically developing school-aged children. These findings assist occupational therapists to understand the impact of screen time on health and participation in children.

Interventions to Promote Physical Activity and Healthy Digital Media Use in Children and Adolescents: A Systematic Review

OBJECTIVES

To identify effective interventions that promote healthy screen time use and reduce sedentary behavior in school-age children and adolescents (SACA) in all settings, over the last 20 years.

METHODS

Searches were conducted from 2000 until March 2021 using PubMed, Embase, Medline, PsycINFO, Ovid SP, The Cochrane Library, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, and the WHO regional databases, including Google Scholar and reference lists of relevant articles and reviews. Randomized-controlled trials and quasi-experimental studies assessing interventions to reduce sedentary behaviors and screen time in healthy SACA (aged 5-19.9 years) globally. Data were extracted by 2 reviewers and where possible, pooled with a random-effects model.

RESULTS

The review included 51 studies, of which 23 were included in meta-analyses with 16 418 children and adolescents. Nondigital randomized-controlled trials reported a small, but significant reduction of TV-specific screen time (minutes per day) (mean difference, -12.46; 95% confidence interval, -20.82 to -4.10; moderate quality of evidence) and sedentary behavior (minutes per day) (mean difference, -3.86; 95% confidence interval, -6.30 to -1.41; participants = 8920; studies = 8; P = .002; moderate quality of evidence) as compared with control groups. For quasi-experimental studies, nondigital interventions may make little or no difference on screen time (minutes per day) or sedentary behavior (minutes per day), given the high uncertainty of evidence. Most studies were conducted in a high-income country. Generalizability of results to low- and middle- income countries remain limited.

CONCLUSIONS

Public health policies and programs will be necessary to reduce excessive sedentary behavior and screen time, especially in the post-coronavirus disease 2019 reality.

Association Among Television and Computer/Video Game Use, Victimization, and Suicide Risk Among U.S. High School Students

With the increasing popularity of mobile Internet devices, the exposure of adolescents to media has significantly increased. There is limited information about associations between the types and frequency of media use and experiences of violence victimization and suicide risk. The current study sought to examine the association of bullying and teen dating violence (TDV) victimization, suicide risk with different types of media use (i.e., television and computer/video game use), and number of total media use hours per school day. Data from the nationally representative 2015 Youth Risk Behavior Survey (n = 15,624) were used to examine the association between media use and violence victimization and suicide risk. Logistic regression models generated prevalence ratios adjusted for demographic characteristics and substance use behaviors to identify significant associations between media use and victimization and suicide risk, stratified by gender. Media use was associated with TDV victimization for male students only, while media use was related to experiences of bullying and suicide risk for both male and female students. In addition, limited (2 or fewer hours) and excessive (5 or more hours) media use emerged as significant correlates of suicide risk and bullying victimization, with limited media use associated with decreased risk and excessive media use with increased risk. Comprehensive, cross-cutting efforts to prevent different forms of victimization should take into account media use and its potential association with adolescent victimization and suicide risk. The current study results suggest limiting adolescent media use, as part of comprehensive prevention programming, might relate to reductions in risk for victimization and suicide.

Associations between Childhood and Adolescent Emotional and Behavioral Characteristics and Screen Time of Adolescents

The correlations between emotional and behavioral problems and increased screen time among young people has been highlighted in the literature. This study examined both longitudinal and cross-directional associations between the degree of childhood and adolescent emotional and behavioral problem characteristics and a higher level of daily screen time in adolescence using an extensive population study. Questionnaires providing data on a representative cohort sample (the Northern Finland Birth Cohort 1986 Study, NFBC 1986; n = 6479; 3101 males) were completed at birth, in childhood, and in adolescence. Male gender, and self-reported behavioral issues (such as a higher degree of hyperactivity/distractibility problems at the beginning of formal schooling and adolescent rule-breaking problems), predicted higher daily screen time in adolescence, after controlling for confounding factors. Higher levels of anxious-depression symptoms among adolescents were inversely related to them having elevated daily digital screen time. Individual behavioral tendencies at the start of formal schooling and later in adolescence may predict higher screen time among young people.

Evaluating Girls on the Run in Promoting Positive Youth Development: Group Comparisons on Life Skills Transfer and Social Processes

PURPOSE

Girls on the Run (GOTR), a physical activity-based positive youth development program, uses running as a platform to teach life skills and promote healthy behaviors. In this companion paper of our comprehensive project, the authors evaluated program impact on positive youth development by comparing GOTR participants to youth in other organized activities (Sport and physical education [PE]) on life skills transfer and social processes. Qualitative methods complemented quantitative data through interviews with GOTR stakeholders.

METHOD

The participants included 215 girls in GOTR and 692 girls in the same grades and schools who did not participate in GOTR (Sport = 485; PE = 207). They completed self-report measures of life skills transfer, peer and coach relatedness, and coach autonomy support at the season's end. GOTR subsamples of girls, coaches, caregivers, and school personnel participated in focus groups.

RESULTS

Girls in GOTR compared favorably to the Sport and PE girls on all life skills-managing emotions, resolving conflicts, helping others, and making intentional decisions-and to the PE girls for all 3 social processes. The GOTR and Sport girls did not differ on coach relatedness and autonomy support, but the Sport girls rated teammate relatedness higher. The GOTR girls' scores on life skills transfer remained stable at a 3-month follow-up assessment. Stakeholders in the focus groups shared corroborating evidence that, through participating in GOTR, girls learn skills that generalize to school and home contexts.

CONCLUSION

Using comparison groups, a retention assessment, and mixed methods, the findings provide evidence that GOTR is effective in teaching skills and strategies that generalize to broader life domains. The processes that explain group differences on life skills transfer include GOTR's intentional curriculum of skill-building activities delivered by coaches within a caring and autonomy-supportive climate.

Screen Time, Physical Activity and Self-Esteem in Children: The Ulm Birth Cohort Study

Screen time is a central activity of children’s daily life and jeopardizes mental health. However, results appear inconclusive and are often based on small cross-sectional studies. We aimed to investigate the temporal sequence of the association between screen time and self-esteem taking into account further indirect effects through family or friendship relationship. In our population-based birth cohort study (baseline November 2000⁻November 2001, Ulm, Germany), these relationships were explored in n = 519 11- and 13-year-old children and their parents who both provided information on children’s screen time: time spent watching television or videos (TV), time spent on computers, video game consoles, mobile devices, or cell phones; so called “other screen time”, and children’s self-esteem (KINDL-R). Time watching TV (self-reported) at age 11 was negatively associated with girls’ self-esteem at the same age but positively with an increase of self-esteem between age 11 and 13. However, the latter association was restricted to low to moderate TV viewers. In boys, a higher increase of other screen time between age 11 and age 13 was associated with lower self-reported self-esteem at age 13. Additionally, friendship relationship mediated the association between watching TV and self-esteem in girls. For parental reports similar associations were observed. These findings indicate that time sequence and potential mediators need further investigation in cohort studies with multiple assessments of screen time and self-esteem.

Media use and psychosocial adjustment in children and adolescents

AIMS

Currently, television and new forms of media are readily available to children and adolescents in their daily lives. Excessive use of media can lead to negative physical and psychosocial health effects. This study aimed to describe children's media use, including media multitasking, as well as the associations between media use and their psychosocial adjustment.

METHODS

This study recruited 339 participants aged 10-15 years from an international school. The children and their care givers were asked to complete the Strengths and Difficulties Questionnaire independently to evaluate the psychosocial problems of the children.

RESULTS

The mean age of the study participants was 12.4 ± 1.5 years, who were recruited from grades 5 to 9. Multitasking media use was reported in 59.3% of participants. The average total media exposure time was 7.0 h/day. The behavioural problem scores from self-reports were greater with increased media use time. After adjusting for confounding variables, the school report and sleep problems were among the factors associated with the total behavioural problem scores from the multiple linear regression analysis (P = 0.001 and <0.001, respectively), whereas age and average total media exposure time were significantly associated with the prosocial behaviour scores reported by the children (P = 0.004 and 0.02, respectively). Multitasking media use was not significantly associated with the total difficulties scores or the prosocial behaviour scores in this study.

CONCLUSION

Increased media use time was significantly associated with decreased prosocial behaviour scores in children in this study. This can provide important information to parents regarding media use in children.

Health behaviours, body weight and self-esteem among grade five students in Canada

Purpose

This study sought to identify the principal components of self-esteem and the health behavioural determinants of these components among grade five students.

Methods

We analysed data from a population-based survey among 4918 grade five students, who are primarily 10 and 11 years of age, and their parents in the Canadian province of Nova Scotia. The survey comprised the Harvard Youth and Adolescent Questionnaire, parental reporting of students’ physical activity (PA) and time spent watching television or using computer/video games. Students heights and weights were objectively measured. We applied principal component analysis (PCA) to derive the components of self-esteem, and multilevel, multivariable logistic regression to quantify associations of diet quality, PA, sedentary behaviour and body weight with these components of self-esteem.

Results

PCA identified four components for self-esteem: self-perception, externalizing problems, internalizing problems, social-perception. Influences of health behaviours and body weight on self-esteem varied across the components. Better diet quality was associated with higher self-perception and fewer externalizing problems. Less PA and more use of computer/video games were related to lower self-perception and social-perception. Excessive TV watching was associated with more internalizing problems. Students classified as obese were more likely to report low self- and social-perception, and to experience fewer externalizing problems relative to students classified as normal weight.

Conclusion

This study demonstrates independent influences of diet quality, physical activity, sedentary behaviour and body weight on four aspects of self-esteem among children. These findings suggest that school programs and health promotion strategies that target health behaviours may benefit self-esteem in childhood, and mental health and quality of life later in life.

Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update

This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth, mean age: 5–17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.

Evaluation development for a physical activity positive youth development program for girls

Girls on the Run (GOTR) is an after school program for girls in third through fifth grade which utilizes a physical activity based positive youth development curriculum that culminates with completing a 5K run. Unfortunately, there is little empirical data documenting GOTR participant changes that align with the curriculum and describe the evaluation process. Therefore, this study presents an evaluation of GOTR consisting of three main processes: curriculum content analysis and stakeholder focus groups (N=11) to identify key outcomes of the program; community-based participatory research to collaborate with program personnel to further identify important outcomes; and the design and pilot testing of an instrument (N=104) for assessing changes in the theoretically grounded outcomes over time. Findings demonstrated a positive collaborative process that led to important information to be used for an impact evaluation of Girls on the Run and for future evaluation development efforts for physical activity based positive youth development.

Sedentary behavior and indicators of mental health in school-aged children and adolescents: A systematic review

OBJECTIVE

The presented systematic review aims at giving a comprehensive overview of studies assessing the relationship between sedentary behavior and indicators of mental health in school-aged children and adolescents.

METHODS

Six online databases (MEDLINE, EMBASE, PsycINFO, PsycARTICLES, CINAHL and SPORTDiscus) as well as personal libraries and reference lists of existing literature were searched for eligible studies.

RESULTS

Ninety-one studies met all inclusion criteria. There was strong evidence that high levels of screen time were associated with more hyperactivity/inattention problems and internalizing problems as well as with less psychological well-being and perceived quality of life. Concerning depressive symptoms, self-esteem, eating disorder symptoms, and anxiety symptoms, no clear conclusion could be drawn. But, taking quality assessment into account, self-esteem was negatively associated with sedentary behavior, i.e. high levels of time engaging in screen-based sedentary behavior were linked to lower scores in self-esteem.

CONCLUSIONS

Overall, the association between sedentary behavior and mental health indicators was rather indeterminate. Future studies of high quality and with an objective measure of sedentary behavior will be necessary to further examine this association as well as to investigate longitudinal relationships and the direction of causality. Furthermore, more studies are needed to identify moderating and mediating variables.

Supportive communication with parents moderates the negative effects of electronic media use on life satisfaction during adolescence

OBJECTIVES

To examine the impact of electronic media (EM) use on teenagers' life satisfaction (LS) and to assess the potential moderating effect of supportive communication with parents (SCP).

METHODS

Data were drawn from the cross-national Health Behaviour in School-aged Children (HBSC) study (2009/2010) in Canada, England, Germany, Hungary, Italy, Israel, The Netherlands, Poland and Scotland. Sample size: 53,973 students aged 11-15 years.

RESULTS

More hours per day spent on the computer were associated with lower LS; more EM communication with friends with higher LS. This relationship became negative if EM use reached and exceeded a certain threshold. SCP moderated the effect of EM communication with friends, but not computer use for the total sample. SCP seems to be more important than computer use or EM communication with friends for LS and it seems to buffer negative effects of EM use.

CONCLUSIONS

Communication with parents seems to buffer the negative effects of EM use on LS during adolescence. Higher computer use was related to lower LS, but "optimal" frequency of EM communication with friends was country specific.

Rationale and study protocol for 'Switch-off 4 Healthy Minds' (S4HM): a cluster randomized controlled trial to reduce recreational screen time in adolescents

INTRODUCTION

Excessive recreational screen time (i.e., screen use for entertainment) is a global public health issue associated with adverse mental and physical health outcomes. Considering the growing popularity of screen-based recreation in adolescents, there is a need to identify effective strategies for reducing screen time among adolescents. The aim of this paper is to report the rationale and study protocol for the 'Switch-off 4 Healthy Minds' (S4HM) study, an intervention designed to reduce recreational screen time among adolescents.

METHODS

The S4HM intervention will be evaluated using a cluster randomized controlled trial in eight secondary schools (N=322 students) in New South Wales, Australia. The 6-month multi-component intervention will encourage adolescents to manage their recreational screen time using a range of evidence-based strategies. The intervention is grounded in Self-Determination Theory (SDT) and includes the following components: an interactive seminar for students, eHealth messaging, behavioral contract and parental newsletters. All outcomes will be assessed at baseline and at 6-months (i.e., immediate post-test). The primary outcome is recreational screen time measured by the Adolescent Sedentary Activity Questionnaire (ASAQ). Secondary outcomes include: self-reported psychological well-being, psychological distress, global physical self-concept, resilience, pathological video gaming and aggression, and objectively measured physical activity (accelerometry) and body mass index (BMI). Hypothesized mediators of behavior change will also be explored.

DISCUSSION

The S4HM study will involve the evaluation of an innovative, theory-driven, multi-component intervention that targets students and their parents and is designed to reduce recreational screen time in adolescents. The intervention has been designed for scalability and dissemination across Australian secondary schools.

The association of screen time, television in the bedroom, and obesity among school-aged youth: 2007 National Survey of Children's Health

BACKGROUND

Among school-aged youth, we sought to identify characteristics associated with (1) exceeding screen time recommendations (ie, television/videos/video games more than 2 hours/weekday), and (2) exceeding screen time recommendations, the presence of a television in the bedroom, and obesity.

METHODS

Using 2007 National Survey of Children's Health data, we used multivariable logistic regression to identify sociodemographic and behavioral characteristics associated with excessive screen time among 6 to 11- and 12 to 17-year-olds on a typical weekday. For 12 to 17-year-olds only, we used logistic regression to examine the odds of obesity using the same variables as above, with the addition of screen time.

RESULTS

Overall, 20.8% of 6 to 11-year-olds and 26.1% of 12 to 17-year-olds had excessive screen time. For both age groups, having a bedroom TV was significantly associated with excessive screen time. For the older age group, the dual scenario of excessive screen time with a bedroom TV had the strongest association with obesity (OR = 2.5, 95% CI 1.9, 3.2).

CONCLUSIONS

Given the similar risk factors for excess screen time and having a TV in the bedroom, a public health challenge exists to design interventions to reduce screen time among school-aged youth.

Physical activity and screen-based media use: cross-sectional associations with health-related quality of life and the role of body satisfaction in a representative sample of German adolescents

Purpose: Although it is widely accepted that physical activity (PA) positively, and screen-based media use (SBM) negatively, affects well-being, there is a lack of studies relating PA and SBM to health-related quality of life (HRQoL) in adolescents. We examined these associations in German adolescents for different HRQoL subdomains and explored the role of body satisfaction as a possible mediator. Methods: The 11–17-year-old subsample of the German Health Interview and Examination Survey (2003–2006) was analysed (N = 6813; 51.3% male). Cross-sectional associations of self-reported PA frequency and amount of daily SBM with HRQoL subscale scores (according to KINDL-R) were examined by hierarchical linear regression models, adjusting for the clustering of the sample and for a variety of possible confounders. The size and significance of indirect effects via body (dis)satisfaction (BDS) were examined by mediation analyses. Results: Higher PA frequency was significantly associated with higher HRQoL on nearly all subscales and dose–response-relationships were observable. Variations were greatest in terms of social well-being in boys (effect size d = 0.59) and physical well-being in girls (d = 0.43). Higher SBM was related to lower HRQoL on all subscales in girls and on some subscales in boys, with the largest effects for school functioning in both genders (d = 0.31 and 0.37, respectively). The mediated effects for PA and SBM were significant in both genders, but the sizes and the proportions of total effects mediated by body satisfaction were rather small. Conclusions: Higher PA frequency was associated with higher self-reported HRQoL, and higher SBM was associated with lower self-reported HRQoL in both genders, even after adjusting for relevant covariates. The results support the assumption of independent health impacts of both behaviours, although no causal relationship can be confirmed with these cross-sectional data. Mechanisms other than body satisfaction must largely account for the effects of PA and SBM on well-being.