Associations among Screen Time and Unhealthy Behaviors, Academic Performance, and Well-Being in Chinese Adolescents

Isotemporal Substitution Effects of Daily Time Use on Cardiorespiratory Fitness of Children in the OptiChild Study: A Mediation Analysis with Diet Quality

(1) Background: Although daily time-use is associated with diet quality and cardiorespiratory fitness (CRF) in children, their interdependence remains unexplored. This study first examined the associations between reallocating daily movement time and diet quality and CRF, and second the mediating role of diet quality in the relationship between daily time-use and CRF. (2) Methods: This study included 1131 Chinese children (aged 8 to 10 years; median [interquartile range]: 8.5 [8.3, 8.8]) at baseline (September 2022) and 1268 children at the 9-month follow-up (June 2023) from the OptiChild study. Daily durations of moderate-to-vigorous physical activity (MVPA), sleep, and sedentary behavior (e.g., screen time) were self-reported or proxy-reported by parents. Diet quality was assessed via the Diet Quality Questionnaire (DQQ), which uses a 24 h dietary recall and is categorized according to the Global Dietary Recommendations (GDR) score and Food Group Diversity Score (FGDS). The CRF was measured using VO2max after the 20 m shuttle run test. Longitudinal associations between daily time-use, diet quality, and CRF were calculated using isotemporal substitution models. Mediation analyses were used to determine whether diet quality mediated the associations between daily time-use and CRF. (3) Results: Reallocation of 30 min from screen time to MVPA resulted in significant improvements in the GDR score (β baseline = 0.11, p = 0.024; β follow-up = 0.26, p < 0.001), FGDS (β baseline = 0.11, p = 0.006; β follow-up = 0.19, p < 0.001), and CRF (β baseline = 0.40, p < 0.001; β follow-up = 0.26, p = 0.001). Diet quality partially mediated the associations between MVPA, screen time, and CRF. Substituting 30 min of screen time for MVPA led to diet quality mediating a proportion of the association with CRF (GDR score: 11.4%, FGDS: 6.6%). (4) Conclusions: These findings underscore the importance of optimizing daily time-use of MVPA and screen time and improving diet quality to promote physical fitness in school-aged children.

Screen viewing patterns and their association with mental wellbeing and psychological distress: a cross-sectional study amongst university students

BACKGROUND

Dependency on screen viewing (SV) has reached unprecedented levels, and mental health issues are becoming a major public health concern. However, the associations between SV, including variations in purposes, devices, and timing, and mental health remain unclear. This study aims to provide insights into these associations among university students.

METHODS

This analysis used baseline data from a longitudinal cohort study among first-year university students matriculating in the 2021-2022 academic year. Self-reported data on sociodemographics, health behaviors and mental health outcomes alongside anthropometric measurements were collected. Unadjusted and adjusted logistic regression analyses were conducted.

RESULTS

The average age of the 997 valid students was 20.2 years, with 59.6% being female and 41.4% male. Students spent 14.3 h daily on SV, with females reporting higher SV than males. Daily SV was predominant for study purposes (7.6 h/day). Computer usage was the highest (7.0 h/day), while TV usage was the lowest (1.7 h/day). Poor mental wellbeing was reported by 33.6% of students, while 13.9% experienced psychological distress. Compared to students with low total SV, those with high levels were more likely to have poor mental wellbeing [OR (95% CI): 1.40 (0.99, 1.98)] and psychological distress [1.56 (1.00, 2.44)]. High levels of recreational and study related SV were significantly associated with poor mental wellbeing [1.81 (1.27, 2.56)] and psychological distress [1.75 (1.11, 2.83)], respectively. Those with high levels of computer time were more likely to have poor mental wellbeing [1.44 (1.01, 2.06)], and high weekend day SV was associated with greater odds of psychological distress [2.16 (1.17, 4.06)].

CONCLUSIONS

SV among university students was high, as was the high prevalence of poor mental wellbeing and psychological distress. Greater SV was associated with poor mental wellbeing and psychological distress. Differences according to purpose of SV were noted. Although recreational SV was associated with poor mental wellbeing, study related SV was associated with psychological distress. Variations across different devices and timing were also noted. This highlights the need for further longitudinal research to understand the impact of SV on mental health and to guide interventions for promoting mental health of university students globally.

Preference for digital media use, biobehavioral attention bias, and anxiety symptoms in adolescents

Adolescence is a critical developmental period of biological and social change during which 1 in 3 youth experience significant anxiety symptoms. The social-emotional lives of the majority of adolescents are largely conducted via digital media use (DMU; e.g., social media, text messaging). Yet the past decade of research on DMU and anxiety has yielded mixed results (e.g., Keles et al., 2020 review), leaving the complex role that DMU might play in the emergence and maintenance of anxiety poorly understood. A key step forward is to leverage psychophysiology to identify individual differences in cognitive and emotional processes that confer vulnerability to potential negative effects of DMU. Further, given the ubiquity of DMU, a greater focus is needed on measurements that move beyond sheer frequency to capture DMU in comparison to face-to-face (FTF) social interactions. This study examined attention bias (AB), characterized by selective and exaggerated attention toward or away from threat, as a moderator of the link between DMU and anxiety in adolescents (N = 75; 42 female) aged 12-14 years (M = 13.28, SD = 0.87). AB was indexed during a dot probe task using reaction time metrics (i.e., trial-level bias) and via ERPs capturing attentional selection and discrimination (N170) and cognitive control (N2) to threat compared to neutral faces. AB moderated associations between DMU and anxiety. A greater preference to use DMU vs FTF predicted greater anxiety among those with a greater behavioral bias away from threat, blunted N170, and blunted N2 in the presence of threat. Future research should examine potential causal and bidirectional links between DMU and anxiety and explore whether preferences for technology-mediated interactions and individual differences in threat processing increase risk.

Self-disgust mediates the effect of problematic mobile social media use on non-suicidal self-injury in adolescents: A latent growth curve analysis

OBJECTIVE

Previous research linked problematic mobile social media use to non-suicidal self-injury (NSSI). However, little research explored the underlying mechanism. Drawing on the social displacement hypothesis, which suggests that excessive social media use may disrupt offline social interactions, leading to negative emotional experiences, the study employs a longitudinal design to explore the relationship between problematic mobile social media use and NSSI, with a specific emphasis on the mediating role of self-disgust.

METHODS

A total of 1,684 Chinese adolescents (52.3% females; Mage = 14.59 years, SDage = 1.27) completed self-report questionnaires regarding problematic mobile social media use, self-disgust, and NSSI. The assessment was conducted in three waves, 6 months apart.

RESULTS

Using latent growth curve and structural equation modeling, our study observed a consistent linear decline in NSSI levels over time. Higher initial NSSI levels correlated with a slower reduction. Problematic mobile social media use positively influenced the initial level of NSSI. Additionally, self-disgust played a mediating role in the relationship between problematic mobile social media use and NSSI.

CONCLUSIONS

The study underscores the importance of understanding the emotional experiences behind social media use, beyond mere usage duration. By revealing the mediating role of self-disgust, it provides new insights into the complex interplay between problematic mobile social media use and adolescent NSSI.

Household food insecurity and its association with academic performance among primary school adolescents in Hargeisa City, Somaliland

BACKGROUND

Academic achievement is crucial for the social and economic development of young people and determines the quality of education of a nation. According to different studies, food insecurity adversely affects children's health, nutrition, and subsequent decline in academic performance by impairing students' ability to learn and therefore affects the achievement of the Sustainable Development Goals (SDGs) of quality education and lifelong learning opportunities for all. To provide evidence on the association of food insecurity with academic performance is necessary. The current study assessed household food insecurity and its association with academic performance among primary school adolescents in Hargeisa City, Somaliland.

METHODS

A school-based cross-sectional study was conducted among 630 primary school adolescents from December 2021 to March 2022. Students were selected using a multistage sampling technique. An interviewer-administered questionnaire was used to collect data on household food security and socio-demographic variables and entered into Epi data version 3.1. The data was exported to SPSS version 26 for descriptive and multivariable logistic regression analysis. Odds ratios and their 95% confidence intervals together with p <0.05 were utilized to declare statistical significance.

RESULTS

The prevalence of food insecurity among school adolescents was 59.21%. The majority (55.40%) of the school adolescents were poor academic performers. The frequency of adolescents' poor academic performance was significantly high (71.05%) among food insecure households (P < 0.001) as compared to their counterparts whose households were food secure (32.68%). On multivariable analysis, household food insecurity (AOR = 5.24, 95%CI = 3.17-8.65), school absenteeism (AOR = 3.49, 95%CI = 2.20-5.53), spending >2h/day watching TV / screen media use (AOR = 9.08, 95%CI = 4.81-17.13), high and middle wealth households (AOR = 0.51, 95%CI = 0.30-0.88) (AOR = 0.40, 95%CI = 0.21-0.76) and habitual breakfast consumption (AOR = 0.08, 95%CI = 0.03-0.20) had shown statistically significant association with academic performance among primary school adolescents.

CONCLUSION

The present study revealed that household food insecurity has a high association with adolescents' academic performance. The prevalence of food insecurity is moderate, based on the household food insecurity access scale. The results indicate the need for policies and programs intended to improve household income by developing income-generation programs for lower-income families and enhance feeding programs such as national school lunch and school feeding across schools in the country.

Identifying protective and risk behavior patterns of online communication in young people

INTRODUCTION

Research has investigated the association between time spent online and mental well-being, however the nuances between specific online behaviors and well-being have been less explored. This research examines how specific online behaviors (i.e., how young people are engaging online and with whom), are associated with one another, and how these patterns of behaviors are related to well-being.

METHODS

We used the November 2020 and March 2021 Understanding Society COVID-19 Panel data. The sample consisted of 1432 adolescents aged 10-15 years, who participated in November 2020. Latent class analysis was used to explore patterns of online behaviors. We also investigated how sociodemographic characteristics differed across the classes, along with physical, social, and mental well-being as distal outcomes both cross-sectionally and longitudinally.

RESULTS

We identified four classes: "Avid users," "Scholars," "Midways," and the "Passengers." The avid users had the highest frequency of posting online content regularly, likewise the scholars also posted online content regularly, however the scholars were differentiated by their higher frequency of schoolwork and news intake online. The midways had more complex activity characterized by talking to friends often and having a social media account, but posted online content less frequently. The passengers were the least active online as they posted pictures and videos less (76% said "never") and only 63% had a social media account. The avid users had the lowest well-being cross-sectionally and longitudinally, and the midways had lower social well-being and appearance dissatisfaction.

CONCLUSIONS

Online behaviors such as regularly posting or talking to internet-only friends could be related to lower well-being. Policymakers should consider both improving regulations online and building an evidence base to enable caregivers from all backgrounds to support young people.

Adolescent coping and social media use moderated anxiety change during the COVID-19 pandemic

INTRODUCTION

Adolescence is a sensitive period during which stressors and social disruptions uniquely contribute to anxiety symptoms. Adolescent's coping strategies (i.e., avoidance and approach) during the coronavirus disease 2019 (COVID-19) pandemic may be differentially related to anxiety symptom changes. Further, social media use (SMU) is ubiquitous and may serve as an avenue to deploy avoidant and/or approach coping.

METHOD

Participants included 265 adolescents (ages 12-20 years; 55.8% female, 43.8% male) and one parent per adolescent. At two time points separated by ~6 months, adolescents reported on SMU and coping strategies, and parents and adolescents reported demographic information and adolescents' anxiety symptoms. Data were collected online in the United States, from summer 2020 through spring 2021.

RESULTS

Increases in avoidant coping predicted increasing anxiety, particularly when approach coping decreased. Decreases in both avoidant coping and SMU coincided with decreasing anxiety. Older adolescents showed decreasing anxiety when avoidant coping declined and SMU increased.

CONCLUSION

Coping strategies and SMU predicted patterns of adolescent anxiety symptom change across 6 months during the COVID-19 pandemic. Results highlight that coping and SMU should be contextualized within the time course of stressors.

Digital consumer behaviour: insights into the perceptions of late adolescents' consumption of digital media on cognitive health

OBJECTIVES

Digital media has become an indispensable facet of adolescents' everyday lives, playing a crucial role in their daily routines, encompassing various activities such as accessing information, accomplishing academic tasks, and facilitating interpersonal communication. Literature evidence on the effects of digital media on cognitive health is bi-directional, having both positive and negative impacts. The present research aimed to explore the perceptions of digital media consumption on cognitive health in late adolescents between the age of 17 and 21 years.

METHODS

A self-reported online survey was administered to 173 adolescents, and the data were analysed using statistical software (SPSS 17).

RESULTS

The findings revealed that some late adolescents recognize the importance of cognition in their daily activities and health, particularly for activities focused on cognitive, academic, personal, and social skills. Mobile phones, laptops, and television were the most commonly preferred gadgets, while e-pads, Alexa, smartwatches, Kindle, tablets, and play stations were less preferred. Interestingly, a high proportion of participants reported neutral perceptions of digital media's influence on cognitive health, highlighting the need to create awareness and educate late adolescents on healthy digital media consumption.

CONCLUSIONS

The findings hold significant implications for the development of comprehensive guidelines and evidence-based recommendations for digital media usage among late adolescents. Additionally, the research sheds light on the strategies adopted by adolescents to regulate and optimize their consumption of digital media, thereby providing valuable insights into effective practices and potential areas for improvement.

A scoping review of social media in child, adolescents and young adults: research findings in depression, anxiety and other clinical challenges

BACKGROUND

Social media and other technologies are reshaping communication and health.

AIMS

This review addresses the relationship between social media use, behavioural health conditions and psychological well-being for youth aged <25 years.

METHOD

A scoping review of 11 literature databases from 2000 to 2020 explored research studies in youth in five areas: clinical depression and anxiety, quantitative use, social media mode, engagement and qualitative dimensions and health and well-being.

RESULTS

Out of 2820 potential literature references, 140 met the inclusion criteria. The foci were clinical depression and anxiety disorders (n = 78), clinical challenges (e.g. suicidal ideation, cyberbullying) (n = 34) and psychological well-being (n = 28). Most studies focused on Facebook, Twitter, Instagram and YouTube. Few studies are longitudinal in design (n = 26), had comparison groups (n = 27), were randomised controlled trials (n = 3) or used structured assessments (n = 4). Few focused on different youth and sociodemographic populations, particularly for low-income, equity-seeking and deserving populations. Studies examined association (n = 120; 85.7%), mediating (n = 16; 11.4%) and causal (n = 4; 2.9%) relationships. Prospective, longitudinal studies of depression and anxiety appear to indicate that shorter use (≤3 h/day) and purposeful engagement is associated with better mood and psychological well-being. Depression may predict social media use and reduce perception of support. Findings provide families, teachers and providers ways to engage youth.

CONCLUSIONS

Research opportunities include clinical outcomes from functional perspective on a health continuum, diverse youth and sociodemographic populations, methodology, intervention and privacy issues. More longitudinal studies, comparison designs and effectiveness approaches are also needed. Health systems face clinical, training and professional development challenges.

Smartphones, social Media and Adolescent mental well-being: the impact of school policies Restricting dayTime use-protocol for a natural experimental observational study using mixed methods at secondary schools in England (SMART Schools Study)

INTRODUCTION

Smartphone and social media use is prevalent during adolescence, with high levels of use associated with lower levels of mental well-being. Secondary schools in the UK have introduced policies that restrict daytime use of smartphones and social media, but there is no evaluation on the impact of these policies on adolescent mental well-being. The SMART Schools Study aims to determine the impact of daytime restrictions of smartphone and social media use on indicators of adolescent mental well-being, anxiety, depression, physical activity, sleep, classroom behaviour, attainment and addictive social media use.

METHODS AND ANALYSIS

This is a natural experimental observational study using mixed methods. Secondary schools within a 100 mile radius of the recruiting centre in the West Midlands (UK) have been categorised into two groups: Schools that restrict (intervention) and permit (comparator) daytime use of smartphones. We aim to recruit 30 schools (20 restrictive, 10 permissive) and 1170 pupils aged 12-13 and 14-15 years. We will collect data on mental well-being, anxiety and depressive symptoms, phone and social media use, sleep and physical activity from pupil surveys, and accelerometers. Policy implementation measures and data on individual pupil factors will be collected through school staff surveys, and website/policy analysis. Six case study schools will explore individual, school and family/home factors that influence relationships between school smartphone policies, smartphone/social media use, and mental well-being. Economic evaluation will be completed through a cost-consequence analysis from an education sector perspective.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the University of Birmingham's Research Ethics Committee (ERN_22-0723). Parents/carers of pupil participants can complete a form to opt their child out of the study. Pupil, school staff and parent/carer participants are asked to complete online/written consent (or assent). Findings will be disseminated through policy briefings, resources for schools, social media, reports, and open access publications.

TRIAL REGISTRATION NUMBER

ISRCTN77948572.

Exploring the Impact of Social Media on Anxiety Among University Students in the United Kingdom: Qualitative Study

BACKGROUND

The rapid surge in social media platforms has significant implications for users' mental health, particularly anxiety. In the case of social media, the impact on mental well-being has been highlighted by multiple stakeholders as a cause for concern. However, there has been limited research into how the association between social media and anxiety arises, specifically among university students-the generation that has seen the introduction and evolution of social media, and currently lives through the medium. Extant systematic literature reviews within this area of research have not yet focused on university students or anxiety, rather predominantly investigating adolescents or generalized mental health symptoms and disorders. Furthermore, there is little to no qualitative data exploring the association between social media and anxiety among university students.

OBJECTIVE

The purpose of this study is to conduct a systematic literature review of the existing literature and a qualitative study that aims to develop foundational knowledge around the association of social media and anxiety among university students and enhance extant knowledge and theory.

METHODS

A total of 29 semistructured interviews were conducted, comprising 19 male students (65.5%) and 10 female students (34.5%) with a mean age of 21.5 years. All students were undergraduates from 6 universities across the United Kingdom, with most students studying in London (89.7%). Participants were enrolled through a homogenous purposive sampling technique via social media channels, word of mouth, and university faculties. Recruitment was suspended at the point of data saturation. Participants were eligible for the study if they were university students in the United Kingdom and users of social media.

RESULTS

Thematic analysis resulted in 8 second-order themes: 3 mediating factors that decrease anxiety levels and 5 factors that increase anxiety levels. Social media decreased anxiety through positive experiences, social connectivity, and escapism. Social media increased anxiety through stress, comparison, fear of missing out, negative experiences, and procrastination.

CONCLUSIONS

This qualitative study sheds critical light on how university students perceive how social media affects their anxiety levels. Students revealed that social media did impact their anxiety levels and considered it an important factor in their mental health. Thus, it is essential to educate stakeholders, including students, university counselors, and health care professionals, about the potential impact of social media on students' anxiety levels. Since anxiety is a multifactorial condition, pinpointing the main stressors in a person's life, such as social media use, may help manage these patients more effectively. The current research highlights that there are also many benefits to social media, and uncovering these may help in producing more holistic management plans for anxiety, reflective of the students' social media usage.

The associations between screen time and mental health in adolescents: a systematic review

BACKGROUND

Adolescents have extensive use of screens and, they have common complains related to mental health. Here a systematic review was done to understand the association between screen time and adolescent's mental health.

METHOD

This review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. An update search was performed in January 2023 with the following keywords: "screen time," "adolescent," and "mental health" on PubMed, PsycINFO and Scopus databases.

RESULTS

50 articles were included, most have found associations between screen exposure and mental health in adolescents. The most used device by adolescents was the smartphone and the use on weekdays was associated with diminished mental well-being. Social media use was negatively associated with mental well-being and, in girls, associated at higher risk for depression.

CONCLUSION

Excessive screen time in adolescents seems associated with mental health problems. Given the profusion and disparity of the results, additional studies are needed to clarify elements such as the screen content or the interaction of adolescents with different screen devices.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022302817.

Screen time among school-aged children of aged 6-14: a systematic review

BACKGROUND

Screen time refers to the time an individual spends using electronic or digital media devices such as televisions, smart phones, tablets or computers. The purpose of this study was to conduct systematic review to analyze the relevant studies on the length and use of screen time of school-aged children, in order to provide scientific basis for designing screen time interventions and perfecting the screen use guidelines for school-aged children.

METHODS

Screen time related studies were searched on PubMed, EMBASE, Clinical Trials, Controlled Trials, The WHO International Clinical Trials Registry Platform, the Cochrane Central Register of Controlled Trials, CNKI, and Whipple Journal databases from January 1, 2016 to October 31, 2021. Two researchers independently screened the literature and extracted the data, and adopted a qualitative analysis method to evaluate the research status of the length and usage of screen time of school-aged students.

RESULTS

Fifty-three articles were included. Sixteen articles studied screen time length in the form of continuous variables. Thirty-seven articles studied screen time in the form of grouped variables. The average screen time of schoolchildren aged 6 to 14 was 2.77 h per day, and 46.4% of them had an average screen time ≥ 2 h per day. A growth trend could be roughly seen by comparing studies in the same countries and regions before and after the COVID-19 outbreak. The average rates of school-aged children who had screen time within the range of ≥ 2 h per day, were 41.3% and 59.4% respectively before and after January 2020. The main types of screen time before January 2020 were watching TV (20 literatures), using computers (16 literature), using mobile phones/tablets (4 literatures). The mainly uses of screens before January 2020 were entertainment (15 literatures), learning (5 literatures) and socializing (3 literatures). The types and mainly uses of screen time after January 2020 remained the same as the results before January 2020.

CONCLUSIONS

Excessive screen time has become a common behavior among children and adolescents around the world. Intervention measures to control children's screen use should be explored in combination with different uses to reduce the proportion of non-essential uses.

Scrolling Through the COVID-19 Pandemic: Exploring the Perceived Effects of Increased Social Media Use on the Mental Health of Undergraduate University Students

Social media has become increasingly integrated into the lives of students for the past decade; however, the public health restrictions associated with the COVID-19 pandemic have led to a sharp increase in social media use in a short period of time. The purpose of this study was to investigate the effects of social media use on university students during the COVID-19 pandemic. Fifteen students from a mid-sized Canadian city were interviewed to share their experiences with social media during the COVID-19 pandemic. Purposive sampling was conducted to gather a diverse sample of participants, including individuals of various ages, gender and sexual identities, and ethnicities. Thematic analysis on the 15 interviews was completed using NVivo (version 12). Participants experienced both advantages and disadvantages associated with social media use. Ease of communication and stress relief were acknowledged as the strongest benefits. Social comparison, loneliness, development of bad habits, and lack of focus were cited as major disadvantages to social media use during the pandemic. Cost-benefit analysis of social media was common, and participants expressed the importance of using social media with moderation, balance, and awareness. Our study indicates that the focus on health with respect to the pandemic should not be solely based on physical health, rather the potential mental health risks associated with social media use during the pandemic should be recognized and addressed by healthcare providers.

The Association Between Screen Time and Outdoor Time on Adolescent Mental Health and Academic Performance: Evidence from Rural China

Purpose

We examine how adolescent free time allocation-namely, screen time and outdoor time-is associated with mental health and academic performance in rural China.

Methods

This paper used a large random sample of rural junior high school students in Ningxia (n = 20,375; age=13.22), with data collected from self-reported demographic questionnaires (to assess free time allocation), the Strengths and Difficulties Questionnaire (to assess mental health), and a standardized math test (to measure academic performance). We utilized a multivariate OLS regression model to examine associations between free time allocation and adolescent outcomes, controlling for individual and family characteristics.

Results

Our sample's screen time and outdoor time both averaged around 1 hour. About 10% of the sample adolescents reported behavioral difficulties, while a similar percentage (11%) reported abnormal prosocial behaviors. Adolescents with higher levels of screen time (>2 hours) were 3 percentage points more likely to have higher levels of behavioral difficulties (p<0.001), indicating that excessive screen time was associated with worse mental health. Meanwhile, outdoor time was associated with better mental health, and positive correlations were observed at all levels of outdoor time (compared to no outdoor time, decreasing the likelihood of higher levels of behavioral difficulties by between 3 and 4 percentage points and of lower prosocial scores by between 6 and 8 percentage points; all p's<0.001). For academic performance, average daily screen times of up to 1 hour and 1-2 hours were both positively associated with standardized math scores (0.08 SD, p<0.001; 0.07 SD, p<0.01, respectively), whereas there were no significant associations between outdoor time and academic performance.

Conclusion

Using a large sample size, this study was the first to examine the association between adolescent free time allocation with mental health and academic performance, providing initial insights into how rural Chinese adolescents can optimize their free time.

The association between meeting physical activity guidelines and academic performance among junior high school adolescents in China-evidence from the China education tracking survey

Purpose

To examine how well Chinese adolescents meet the physical exercise time and screen time recommendations in the Physical Activity Guidelines for Chinese Residents (2021), and the relationship between adolescents' physical exercise time, screen time and their academic performance.

Method

Daily physical exercise time, screen time and academic performance were collected from Grade 8 adolescents (n = 9,449). Academic performance included standardized scores on Chinese, Math and English tests and responses to the School Life Experience Scale.

Results

Meeting the physical activity time and screen time in the Physical Activity Guidelines for Chinese Residents was associated with adolescents' academic performance. Specifically, having at least 60 min of physical exercise per day was associated with adolescents' school life experiences compared to adolescents who did not meet the physical exercise time and screen time in the Chinese Residents' Physical Activity Guidelines. Less than 2  h of cumulative screen time per day was associated with adolescent mathematics test scores, English test scores and school life experiences. Meeting both physical exercise time and screen time to be recommended had more significant effects on adolescents' mathematics, Chinese, English and school life experiences. Meeting both the physical exercise time and screen time recommendations in the Physical Activity Guidelines for Chinese Residents was more significantly associated with boys' mathematics test scores, Chinese test scores and School life experience. Meeting both the physical exercise time and screen time requirements in the Physical Activity Guidelines for Chinese Residents had a more significant effect on School life experience for girls.

Conclusion

Physical exercise participation of at least 60 min per day and/or less than 2  h of cumulative screen time per day were both associated with adolescent academic performance. Stakeholders should actively promote adolescents to follow the Physical Activity Guidelines for Chinese Residents (2021).

#BlueGirl: A study of collective trauma on Twitter

Collective trauma is the outcome of traumatic incidents that necessitate collective self-reflection and create a need for public discourse. Access to social media allows individuals to shape event coverage beyond what is put forth by mainstream media through hashtag-based communities. The death of Sahar Khodayari, or "Blue Girl," an Iranian woman who committed suicide after being sentenced to prison for appearing in a sports stadium dressed as a man, is one such event that became a collective trauma. The current study sought to examine the collective trauma reaction among Farsi-speaking Twitter users in response to Khodayari's death as represented in public tweets. The overall pool of data consisted of 8,653 tweets containing at least one of four hashtags (i.e., #BlueGirl, #Blue_Girl,, # #), posted September 9-24, 2019, as well as 603 tweets posted on the anniversary of the event 1 year later. Using thematic analysis, we identified three main themes within these public tweets representing different responses to Khodayari's death: social justice, awareness, and process. In undemocratic countries, like Iran, where there are limited free physical spaces for public gatherings, social media provides a platform for people to come together after tragic events to express emotions and discuss thoughts and actions. The present findings demonstrate that Twitter allowed Farsi-speaking users to demand social justice, share awareness about #BlueGirl, and process their emotions and thoughts accordingly. Therefore, social media may provide a window into the collective trauma experience, and it may also serve as a new mode of studying trauma on new platforms.

The effect of social media on the development of students’ affective variables

The use of social media is incomparably on the rise among students, influenced by the globalized forms of communication and the post-pandemic rush to use multiple social media platforms for education in different fields of study. Though social media has created tremendous chances for sharing ideas and emotions, the kind of social support it provides might fail to meet students’ emotional needs, or the alleged positive effects might be short-lasting. In recent years, several studies have been conducted to explore the potential effects of social media on students’ affective traits, such as stress, anxiety, depression, and so on. The present paper reviews the findings of the exemplary published works of research to shed light on the positive and negative potential effects of the massive use of social media on students’ emotional well-being. This review can be insightful for teachers who tend to take the potential psychological effects of social media for granted. They may want to know more about the actual effects of the over-reliance on and the excessive (and actually obsessive) use of social media on students’ developing certain images of self and certain emotions which are not necessarily positive. There will be implications for pre- and in-service teacher training and professional development programs and all those involved in student affairs.

Do dietary patterns differ with video game usage in college men?

Objective: To assess differences in dietary quality among college men reporting high, moderate, and non-video game usage. Participants: College men aged 18-24. Methods: Cross-sectional data were collected between 2012 and 2020. Participants (n = 1259) were categorized according to self-reported video game usage: non-users (NVG), <1 h/day (MVG), and ≥1 h/day (HVG). ANCOVA identified group differences in nutrient intake from 3-day food records. Results: College men reported 30% NVG, 39% MVG, and 31% HVG. Higher saturated fat (30.2 ± 0.4 g and 30.1 ± 0.3 g, vs. 28.5 ± 0.4 g, p < .01, p < .01) and lower fruit/vegetable intake (3.00 ± 0.1 cups and 2.91 ± 0.1 cups, vs. 3.45 ± 0.1 cups, p < .00, p < .00) was observed in HVG and MVG vs. NVG. Higher discretionary calories (750 ± 13 kcals, vs. 686 ± 13 kcals, p < .00) in HVG and sodium (3922 ± 44 mg, vs. 3860 ± 50 mg, p < .02) in MVG were reported vs. NVG. Conclusion: Video game usage was associated with higher saturated fat, sodium, discretionary calories, and lower F/V intake in college men.

Student achievement prediction using deep neural network from multi-source campus data

Finding students at high risk of poor academic performance as early as possible plays an important role in improving education quality. To do so, most existing studies have used the traditional machine learning algorithms to predict students’ achievement based on their behavior data, from which behavior features are extracted manually thanks to expert experience and knowledge. However, owing to an increase in the varieties and overall volume of behavioral data, it has become more and more challenging to identify high-quality handcrafted features. In this paper, we propose an end-to-end deep learning model that automatically extracts features from students’ multi-source heterogeneous behavior data to predict academic performance. The key innovation of this model is that it uses long short-term memory networks to capture inherent time-series features for each type of behavior, and it takes two-dimensional convolutional networks to extract correlation features among different behaviors. We conducted experiments with four types of daily behavior data from students of the university in Beijing. The experimental results demonstrate that the proposed deep model method outperforms several machine learning algorithms.

The Relationship of Social Media Addiction With Internet Use and Perceived Health: The Moderating Effects of Regular Exercise Intervention

The popularity of online social media in recent years has not only brought information and social convenience to people's lives, but has also given rise to many problems, among which social media addiction (SMA) has become a concern of many scholars and experts. Past research has shown that regular exercise (REx) can have many health benefits for the body, so numerous scholars and experts believe that this may be one possible strategy for reducing the health effects of online community addiction and Internet use (IU). Therefore, this study adopted a secondary data research approach to explore and predict the effect of age on social media use and personal health, and therefore included age as a control variable to investigate whether the intervention of REx, excluding the effect of age, moderates the effect of SMA on IU and on perceived health (PH). The participants of this study were adults aged 18 years or older in Taiwan, using the 2019 "Survey Research Data Archive," Vol. 7, No. 5 data. A total of 1,933 questionnaires were retrieved, and after elimination of invalid responses, 1,163 data were analyzed using Partial Least Squares Structural Equation Modeling, PLS-SEM. The results were as follows: (1) SMA positively affected IU, (2) SMA could negatively affect PH, (3) there was no statistical effect of IU on PH, (4) SMA did not indirectly affect PH through IU, (5) REx had a moderating effect on SMA and IU, and (6) REx did not regulate the effect of SMA on PH. First, from these results, it is clear that the negative health effects of SMA may not be simply due to prolonged IU. Secondly, while it is true that the moderating effect for people with low levels of SMA can reduce IU, for people with high levels of SMA, the moderating effect of REx becomes a catalyst for increased Internet usage behavior. Finally, we draw conclusions based on the results of the study and propose directions and recommendations for follow-up research.

Predictors of Academic Performance in High School Students: The Longitudinal ASAP Study

Academic performance is influenced by multitude factors. However, little is known about their relative importance and how they evolve over time. The purpose of the present study was to determine the relative importance of cognitive control, physical, psychological and sociological factors as well as lifestyle habits in predicting academic performance in high school students using cross sectional and longitudinal approaches. One hundred and eighty-five grade seventh to ninth students (mean age: 13.1 ± 1.0 years old) from a single high school completed a 3-year prospective study. Academic performance, cognitive control, physical, psychological and sociological factors as well as lifestyle habits were assessed every year during the 3-year study. Results showed that different combinations of factors were found to predict academic performance measures in both male and female students at baseline and after a 3-year period. For example, in female students, screen time and VO₂ max were found to be important predictors of academic performance, whereas working memory was the only recurring factor in predicting academic performance in male students. Moreover, our models were able to explain between 6.1 to 52.2% of the variation in the change of the different measures of academic performance. Results of the present study show that academic performance may be predicted by a wide range of multiple factors in high school students. Indeed, the factors that predicted academic performance varied between school subjects, sex and study design, highlighting the complexity of predicting academic performance in high school students.

Frequent Social Media Use and Its Prospective Association With Mental Health Problems in a Representative Panel Sample of US Adolescents

PURPOSE

This study examined the relationship between frequent social media use and subsequent mental health in a representative sample of US adolescents. Also investigated were sex differences in multiyear growth trajectories of mental health problem internalization relative to social media use.

METHODS

Four waves (2013-2018) of nationally representative, longitudinal Population Assessment of Tobacco and Health data were analyzed. A total of 5,114 US adolescents aged 12-14 years at baseline had repeated data across all waves. Statistical analysis involved testing a series of sequential-weighted single-group and multi-group latent growth curve models using R version 3.6.2.

RESULTS

Of the 5,114 respondents, 2,491 were girls (48.7%). The percentage of frequent social media use was 26.4% at Wave 1 and 69.1% at Wave 4 for boys compared to 38.3% and 80.6% for girls (p < .001). Boys showed an improving (-0.218, p = .005) but girls showed a deteriorating linear trend (0.229, p = .028) for mental health at the full multigroup latent growth curve model. Social media use accounted for mental health conditions across Waves 1-3 for boys (ps<.01) but only at Wave 1 for girls (p = .035). With the addition of the social media use variable alone, model fit dramatically improved, and residual variances in growth patterns (i.e., random effect) became nonsignificant for boys. Substantial sex differences existed in baseline status, directionality, and shape of mental health growth trajectories as well as interplay of social media use with other factors.

DISCUSSION

Findings of the study suggest that frequent social media use is associated with poorer subsequent mental health for adolescents.

Independent and combined associations between multiple lifestyle behaviours and academic grades of inner urban and peri-urban high school students: a cross-sectional study in Chongqing, China

OBJECTIVES

This study aims to assess the independent and combined associations between multiple lifestyle behaviours and academic grades of inner urban high school students (IUHSSs) and peri-urban high school students (PUHSSs).

DESIGN

A cross-sectional study was conducted.

PARTICIPANTS

There are 1481 high school students (49.9% boys) in this study, who were enrolled from one inner urban and two peri-urban schools in Chongqing, China.

OUTCOME MEASURES

Academic grades were assessed based on the students' self-reported grade ranking in the last cumulative examination.

RESULTS

In IUHSSs and PUHSSs, high frequency of sugar-sweetened beverage consumption was unlikely to obtain high academic grades (OR 0.56, 95% CI 0.32 to 0.99 and 0.63, 95% CI 0.42 to 0.96), respectively). Among IUHSSs, meeting the recommendations for weekday screen time and egg consumption (OR 1.57, 95% CI 1.06 to 2.34 and 1.60, 95% CI 1.04 to 2.47, respectively) and high frequency of fruit consumption (1.67, 95% CI 1.11 to 2.50) were significantly associated with high academic grades; meeting the recommendation for weekday sleep duration was unlikely to obtain high academic grades (0.46, 95% CI 0.21 to 0.98). Among PUHSSs, meeting the recommendations for weekend sleep duration (1.40, 95% CI 1.02 to 1.93) and eating dinner regularly (1.55, 95% CI 1.01 to 2.37) had significant associations with high academic grades. No significant associations were found between physical activity and academic grades in both IUHSSs and PUHSSs (p>0.05). Moreover, IUHSSs with 9-13 healthy lifestyle behaviours were 3.25 times more likely to achieve high academic grades than IUHSSs with 1-6 healthy lifestyle behaviours (3.25, 95% CI 1.96 to 5.40). No significant associations were found in the combined associations between multiple lifestyle behaviours and academic grades among PUHSSs (p>0.05).

CONCLUSIONS

Correlations were observed between lifestyle behaviours and academic grades among high school students, and cumulative associations between multiple healthy lifestyle behaviours and academic outcomes appear to be stronger than the independent associations. These findings are particularly applicable to IUHSSs.

Roles of Psychosocial Factors on the Association Between Online Social Networking Use Intensity and Depressive Symptoms Among Adolescents: Prospective Cohort Study

BACKGROUND

The potential mechanisms underlying the association between online social networking use intensity and depressive symptoms are unclear and underresearched.

OBJECTIVE

We aimed to investigate the potential roles of interpersonal psychosocial factors on the association between online social networking use intensity and depressive symptoms among early adolescents.

METHODS

A total of 4237 adolescents from a 9-month longitudinal study were included. Score changes (indicated as △) for the social function use intensity (SFUI) and entertainment function use intensity (EFUI) subscales of the Online Social Networking Activity Intensity Scale and for friendship quality, perceived family support, perceived friend support, parent-adolescent conflict, social nonconfidence, and depressive symptoms were analyzed. The potential mediation effects of unfavorable psychosocial factors and suppression effects of favorable psychosocial factors on the association of △SFUI with △CES-D and the association of △EFUI with △CES-D were tested using hierarchical regression models.

RESULTS

The association between △SFUI and △CES-D was partially mediated by △mother-adolescent conflict (mediation effect size 5.11%, P=.02) and △social nonconfidence (mediation effect size 20.97%, P<.001) but partially suppressed by △friendship quality, △perceived family support, and △perceived friend support, with suppression effects of -0.011 (P=.003), -0.009 (P=.003), and -0.022 (P<.001), respectively. The association between △EFUI and △CES-D was partially mediated by △social nonconfidence (mediation effect size 30.65%, P<.001) but partially suppressed by △perceived family support and △perceived friend support, with suppression effects of -0.036 (P<.001) and -0.039 (P<.001), respectively.

CONCLUSIONS

The association between online social networking use intensity and depressive symptoms was partially mediated through the indirect increase in social nonconfidence and mother-adolescent conflict; however, better perceived social support and friendship quality would partially compensate for the harmful impact of online social networking use intensity on depressive symptoms among early adolescents.

Screen time and early adolescent mental health, academic, and social outcomes in 9- and 10- year old children: Utilizing the Adolescent Brain Cognitive Development ℠ (ABCD) Study

In a technology-driven society, screens are being used more than ever. The high rate of electronic media use among children and adolescents begs the question: is screen time harming our youth? The current study draws from a nationwide sample of 11,875 participants in the United States, aged 9 to 10 years, from the Adolescent Brain Cognitive Development Study (ABCD Study®). We investigate relationships between screen time and mental health, behavioral problems, academic performance, sleep habits, and peer relationships by conducting a series of correlation and regression analyses, controlling for SES and race/ethnicity. We find that more screen time is moderately associated with worse mental health, increased behavioral problems, decreased academic performance, and poorer sleep, but heightened quality of peer relationships. However, effect sizes associated with screen time and the various outcomes were modest; SES was more strongly associated with each outcome measure. Our analyses do not establish causality and the small effect sizes observed suggest that increased screen time is unlikely to be directly harmful to 9-and-10-year-old children.

Association between the use of social networking sites and mental health of young generation in Bangladesh: A cross-sectional study

The social networking sites (SNS) are popular among people of all levels. Here we aimed to evaluate the relationship between the use of SNS and the mental health of the young generation in Bangladesh. We conducted this cross-sectional study among 791 subjects aged between 15 and 40 years. Self-reported questionnaires were used to collect demographics and SNS usage patterns of the respondents. We have measured the levels of loneliness, depression, generalized anxiety, and sleep disturbance using the recommended mental health assessment scales. The estimations of loneliness, depression, generalized anxiety, and sleep disturbance among the respondents were 64%, 38%, 63%, and 75%, respectively. Young adults, female sex, unmarried individuals, students, and urban residents reported higher psychological issues regarding the SNS use. Reported mental health issues were associated with time spent in SNS, the number of friends and groups connected with, personal beliefs, and feeling about SNS. A notable association between the use of SNS and the mental health issues of users has been ascertained. The present study findings might have significant implications in the field of clinical psychology and psychotherapy. Therefore, we recommend more comprehensive clinical interventions to find the tangible impact of SNS on the mental health of users.

Recreational Screen Time and Anxiety among College Athletes: Findings from Shanghai

To better understand the behavioral factors contributing to the mental health status among student athletes, we examined the link between recreational screen time and college student athlete’s anxieties. This cross-sectional study was conducted among 278 college student athletes from Shanghai, China, aged between 17 and 25 years old (M = 19.4, SD = 1.5). Multivariate regression analyses, controlled for age, gender, rural vs. urban residency, and individual vs. team sports factors, were performed to analyze the association between their average daily recreational screen time in a week and their dispositional anxiety, pre-competition anxiety, and anxiety during competition, which were measured by the Chinese version of validated psychometric scales among athlete population. Significant results were found in both dispositional anxiety and situational anxiety in relation to recreational screen time among college athletes. Conclusions: Our findings indicate that excessive recreational screen time is a risk indicator of college student athletes’ dispositional anxiety, pre-competition anxiety, and anxiety during competition.

Context, Development, and Digital Media: Implications for Very Young Adolescents in LMICs

The rapidly expanding universe of information, media, and learning experiences available through digital technology is creating unique opportunities and vulnerabilities for children and adolescents. These issues are particularly salient during the developmental window at the transition from childhood into adolescence. This period of early adolescence is a time of formative social and emotional learning experiences that can shape identity development in both healthy and unhealthy ways. Increasingly, many of these foundational learning experiences are occurring in on-line digital environments. These expanding vulnerabilities and opportunities are being further amplified for young adolescents growing up in low resourced settings around the world. Cultural and contextual factors influence access, use, and appropriation of digital technology. Further, neurobehavioral changes associated with the onset of puberty often coincide with entry into social media and more autonomous use of technology. In low-and-middle-income countries (LMICs), disparities in access, use, and appropriation of digital media can amplify prevailing economic gaps, and compound gender inequalities during early adolescence. In LMICs, adolescents are often the early adopters of mobile technology and social media platforms. While the impact of social media on the well-being, particularly mental health, of young adolescents has been a focus of research in high-income countries (HICs), much less is known about the impacts of social media use on young adolescents in LMICs. In this paper, we review what is known about the interaction between digital media and early adolescent development. We highlight crucial gaps in the evidence in LMICs; and describe some hypotheses and areas for future research to address these compelling issues.

Online Learning Performances of Children and Adolescents With Attention Deficit Hyperactivity Disorder During the COVID-19 Pandemic

To investigate attention deficit hyperactivity disorder (ADHD) core symptoms that impair executive function (EF), emotional state, learning motivation, and the family and parenting environment of children and adolescents with ADHD, both with and without severe difficulties. This will be explored within an online learning environment during the period of COVID-19 pandemic. A total of 183 ADHD children diagnosed using DSM-V criteria were selected and divided into 2 groups high difficulties during online learning (HDOL) and low difficulties during online learning (LDOL) according to the answer of Home Quarantine Investigation of the Pandemic (HQIP). The participants filled out a set of questionnaires to assess their emotional state and learning motivation, and their parents also filled out the questionnaires about ADHD core symptoms, EF, and family and parenting environment. Compared with ADHD children in the LDOL group, the children in the HDOL group had significant symptoms of inattention, hyperactivity, oppositional defiant, behavioral and emotional problems according to the Swanson, Nolan, and Pelham Rating Scale (SNAP). They also had more severely impaired EF according to the Behavior Rating Inventory of Executive Function (BRIEF), more difficulties and disturbances in the family by the Chinese version of Family Environment Scale (FES-CV), and lower parenting efficacy and satisfaction by Parenting Sense of Competence (PSOC). With regard to the self-rating questionnaires of children and adolescents, the HDOL group reported lower learning motivation according to the Students Learning Motivation Scale (SLMS). By Screening for Child Anxiety-Related Emotional Disorders and Depression Self-Rating Scale for Children (DSRSC), those in HDOL presented more negative emotions. The HDOL group spent significantly more time on both video games and social software per day and significantly less time on multiple activities per week, when compared to those in the LDOL group. This study demonstrated that ADHD children and adolescents with HDOL had more inattention-related behaviors, more severe emotional problems and EF impairment, weaker learning motivation, and poorer family and parenting environment. Meanwhile, digital media use should be supervised and appropriate extracurricular activities should be encouraged by parents and schools.

Association of screen time and sleep duration among Spanish 1-14 years old children

BACKGROUND

Due to the change in screen time usage in the last decade, there is needed to add more evidence about the relationship of screen time and sleep duration.

OBJECTIVE

To assess the association between screen time and sleep duration among Spanish children between 1 and 14 years old.

METHODS

We used data from the 2017 Spanish National Health survey, conducted on a representative sample of the Spanish population. We categorised daily leisure screen time as 0-59, 60-119, 120-179, and ≥180 minutes. We classified sleep duration, depending on the age, as proper sleep duration and short sleep duration. We calculated unadjusted, and adjusted prevalence ratio (PR) and 95% confidence interval (CI) of short sleep duration according to daily leisure screen time after adjusting for potential confounders. PR's were derived from fitting generalised linear models with Poisson distribution and robust variance.

RESULTS

Of the 5517 Spanish children aged 1-14 years, 44.3% spent 120 minutes or more of daily leisure screen time and 23.6% had short sleep duration. 24.5% and 28.2% of children spending between 120 and 179 minutes and exceeding 180 minutes of daily leisure screen time suffered short sleep duration, respectively. In the adjusted model, higher patterns of daily leisure screen time were associated with short sleep duration: adjusted PR_120-179  = 1.34 (95% CI 1.18, 1.54) and adjusted PR_≥180  = 1.48 (95% CI 1.27, 1.73).

CONCLUSIONS

Around one out of four Spanish children between 1 and 14 years old, exceeding 120 minutes of daily leisure screen time, had short sleep duration. More scientific research is needed for institutions to work on providing novel healthcare programmes that consider these new determinants of child health.

Higher emotional investment in social media is related to anxiety and depression in university students

Objectives

Most studies that have reported the adverse effects of social media (SM) usage on mental health have been conducted on adolescents. Additionally, such studies have used frequency or duration as the only indicator of SM usage. The present study aims to relate SM usage (frequency, duration, and emotional investment) with anxiety, depression, and self-esteem in university students.

Methods

In this cross-sectional study, we adapted a non-probability convenience sampling technique. The data from 893 university students was collected through questionnaires, which were developed in Google forms and their links were shared in social media groups. The study tools used were Hospital Anxiety and Depression Scale, Rosenberg self-esteem scale, Social Integration and Emotional Connection subscale of the Social Media Use Integration Scale. We recorded variables for overall SM use (volume and frequency), night-time specific SM usage, emotional investment in SM, anxiety, depression, and self-esteem levels. Based on the scores achieved in SM variables, participants’ data were classified into different quartiles.

Results

We found a significant positive correlation of emotional investment in SM with anxiety (r = 0.71; p-value < 0.001) and depression (r = 0.72; p-value 0.003). The results of the one-way ANOVA revealed significantly increased anxiety and depression scores (p-value 0.03 and 0.02, respectively) in quartile four versus quartile one. The probability or likelihood of being anxious and depressed significantly increased by factors of 1.76 and 1.48, respectively with per unit increase in emotional investment in SM.

Conclusion

Higher Emotional Investment in Social Media is related to Anxiety and Depression in University Students. The probability of being anxious and depressed significantly increases with per unit increase in emotional investment in SM.

Psychological Correlates of Sedentary Screen Time Behaviour Among Children and Adolescents: a Narrative Review

PURPOSE OF REVIEW

The aims of this narrative review were to (1) synthesise the literature on the relationship between screen time and important mental health outcomes and (2) examine the underpinning factors that can influence this association.

RECENT FINDINGS

Paralleling the rise of mental health issues in children and adolescents is the ubiquitous overuse of screens, but it is unclear how screen time is related to important mental health outcomes and whether this association differs by gender, age and screen type.

METHODS

Medline/PubMed, PsychINFO and Google Scholar databases were searched on December 2019 for articles published mainly in the last 5 years. The search focused on two main concepts: (i) screen time and (ii) mental health outcomes including anxiety, depression, psychological and psychosocial well-being and body image concerns.

RESULTS

Sixty studies were included in the review. Higher levels of screen time were associated with more severe depressive symptoms. We found moderate evidence for an association between screen time and poor psychological well-being and body dissatisfaction especially among females. Relationships between screen time and anxiety were inconsistent and somewhat gender specific. Social media use was consistently associated with poorer mental health. Higher levels of screen time are generally associated with poorer mental health outcomes, but associations are influenced by screen type, gender and age. Practitioners, parents, policy makers and researchers should collectively identify and evaluate strategies to reduce screen time, or to use screens more adaptively, as a means of promoting better mental health among children and adolescents.

Activity-Inactivity Patterns, Screen Time, and Physical Activity: The Association with Overweight, Central Obesity and Muscle Strength in Polish Teenagers. Report from the ABC of Healthy Eating Study

Today, the time spent actively is increasingly being replaced by screen-based media, although in some teenagers, a high level of physical activity (PA) and longer time spent in front of a screen (screen time, ST) may coexist as a mixed behavioral pattern. This study aimed to examine the association of the pattern created as activity (low/high ST with high PA) and inactivity patterns (low/high ST with low PA) with overweight, central obesity, and muscle strength in Polish teenagers taking into consideration socioeconomic and demographic factors. Cross-sectional data were collected from elementary school children (n = 1567), aged 11–13 years. Height, weight, waist circumference, and handgrip strength were measured. Body mass index (BMI) was calculated as the overweight measure, and the waist-to-height ratio (WHtR) was calculated as the central obesity measure. Data on ST, PA, socioeconomic status, demographics, and nutrition knowledge were collected by a questionnaire. Activity–inactivity patterns were defined by an a priori approach. Multivariate logistic regression modelling was applied. The most active pattern (lowST-highPA) was found in 17% of the total sample. Teenagers with the most inactive pattern (highST-lowPA) had over four times higher chance of general overweight. No association between WHtR ≥0.5 and highST-highPA pattern was found. Higher muscle strength (>1 SD) was associated only with high physical activity. Urban residence or lower socioeconomic status increased adherence to the most inactive pattern. From a public health perspective, implementing interventions promoting active patterns in 11–13-year-old teenagers is important for obesity prevention and enhanced physical fitness, especially in girls, teenagers living in urban areas, and from families with lower socio-economic status.

Psychological impacts of "screen time" and "green time" for children and adolescents: A systematic scoping review

Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5-11 years), early adolescents (12-14 years), and older adolescents (15-18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era.

Social Media Use and Mental Health and Well-Being Among Adolescents - A Scoping Review

Introduction: Social media has become an integrated part of daily life, with an estimated 3 billion social media users worldwide. Adolescents and young adults are the most active users of social media. Research on social media has grown rapidly, with the potential association of social media use and mental health and well-being becoming a polarized and much-studied subject. The current body of knowledge on this theme is complex and difficult-to-follow. The current paper presents a scoping review of the published literature in the research field of social media use and its association with mental health and well-being among adolescents. Methods and Analysis: First, relevant databases were searched for eligible studies with a vast range of relevant search terms for social media use and mental health and well-being over the past five years. Identified studies were screened thoroughly and included or excluded based on prior established criteria. Data from the included studies were extracted and summarized according to the previously published study protocol. Results: Among the 79 studies that met our inclusion criteria, the vast majority (94%) were quantitative, with a cross-sectional design (57%) being the most common study design. Several studies focused on different aspects of mental health, with depression (29%) being the most studied aspect. Almost half of the included studies focused on use of non-specified social network sites (43%). Of specified social media, Facebook (39%) was the most studied social network site. The most used approach to measuring social media use was frequency and duration (56%). Participants of both genders were included in most studies (92%) but seldom examined as an explanatory variable. 77% of the included studies had social media use as the independent variable. Conclusion: The findings from the current scoping review revealed that about 3/4 of the included studies focused on social media and some aspect of pathology. Focus on the potential association between social media use and positive outcomes seems to be rarer in the current literature. Amongst the included studies, few separated between different forms of (inter)actions on social media, which are likely to be differentially associated with mental health and well-being outcomes.

Sedentary Behavior Research in the Chinese Population: A Systematic Scoping Review

Background: The negative effects of sedentary behavior (SB) on public health have been extensively documented. A large number of studies have demonstrated that high prevalence of SB is a critical factor of all-cause mortality. Globally, the frequency of SB research has continued to rise, but little is known about SB in the Chinese population. Therefore, this review was conducted to scope the research situation and to fill the gaps related to the effects of SB in the Chinese population. Methods: Using a scoping review based on York methodology, a comprehensive search of published journal articles and grey literature was carried out through 12 databases. The literature research was conducted by two authors in July 2019, and included journal articles that targeted on the Chinese population were published between 1999 and 2019. The two authors screened the records independently and included those research topics related to SB in the Chinese population. Results: The number of included studies increased from 1 to 29 per year during the analyzed period, during which, a remarkable climb happened from 8 in 2013 to 19 in July 2019. Out of the 1303 screened studies, a total of 162 studies (81 English and 81 Chinese journal articles) met the inclusion criteria in this review. Most of the included studies (66.0%) reported the overall estimated prevalence of SB, in which, 43.2% of studies reported the average time of SB, and 40.0% of studies reported the cutoff point of SB. Besides this, 54.9% and 23.5% of studies focused on the outcomes and correlates/determinants of SB, and the proportions of studies based on testing the validation of measurement tools and on interventions were 3.7% and 4.9%, respectively. Nearly all of the reviewed articles used data from cross-sectional studies (75.9%) and longitudinal studies (13.6%), while intervention trials are less developed. The majority of the studies (64.8%) used self-reported surveys, and only 3.7% studies used device-based measurement tools. Furthermore, 35.8% of the included studies were focused on children and adolescents, while only a few studies investigated infants/toddlers and older adults. Both female and male were examined in most studies, and non-clinical populations were investigated in the context of SB in a relatively large number of studies. Conclusions: The number of research articles on SB in the Chinese population published per year has increased year by year, indicating a growing interest in this research area. More studies using population subgroup samples are needed, particularly among infants/toddlers, older adults, and clinical populations. To provide stronger evidence of the determinants and outcomes of SB, longitudinal studies using device-based measures of SB are required.

Reduced Screen Time is Associated with Healthy Dietary Behaviors but Not Body Weight Status among Polish Adolescents. Report from the Wise Nutrition-Healthy Generation Project

Screen time (ST) not only affects physical activity but can also be associated with dietary behaviors. Both of these factors determine the health and development of adolescents. The aims of the study were: 1. to analyze the relationship between ST and nutritional behaviors among adolescents; 2. to examine this association in relation to body weight status. Data on the ST duration and nutritional behaviors were collected using a questionnaire. Body mass status was assessed based on weight and height measurements. A total of 14,044 students aged 13–19 years old from 207 schools participated in the study. A significant relationship between ST and gender, age and type of school was observed, but not body weight status. The average ST duration increased with age (from 2.6 h among 13 years old to 3.2 h among 19 years old), and was significantly higher among boys in all age categories (2.7 h vs. 2.5 h in the youngest age group, and 3.5 h vs. 3.0 h in the oldest age group, respectively). The chance for meeting the recommendation for ST in a group of girls (regardless of age) was almost 50% higher compared to boys. Meeting ST recommendation (≤2 h) was associated with a greater odds ratio for favorable nutritional behaviors in the whole group, with exception of drinking milk or milk beverages, and significantly reduced the odds ratio of adverse dietary behaviors (drinking sweet beverages, consumption of sweets and fast food) in the whole group and by gender. More research is needed to clarify the possible cause-and-effect relationships between ST and dietary behaviors.

The relationship between screen-based sedentary behaviors and symptoms of depression and anxiety in youth: a systematic review of moderating variables

Background

To elucidate the populations and conditions where screen-based sedentary behaviors (SB) and internalizing symptoms are coupled, this review synthesized the evidence for factors that may moderate the associations between screen-based SB, depressive symptoms, and anxiety symptoms among youth.

Methods

Two independent researchers conducted a systematic literature search of the Medline, psycINFO, and Scopus electronic databases in late 2018 for observational studies assessing moderators of the association between screen-based SB and depressive and anxiety symptoms. Studies among children and adolescents were eligible if moderation was assessed by statistical test (interaction) or stratification; and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines.

Results

Seventy empirical studies (46 cross-sectional, 19 longitudinal, and 5 both) of 13 different moderating variables of screen-based SB-internalizing symptom associations met the eligibility criteria. Of these, 40 studies were of depressive symptoms, 2 were of anxiety symptoms, and 28 studies assessed symptoms of both. The most consistent evidence of moderation was for screen-type, such that TV viewing was not as strongly associated with internalizing symptoms compared to other forms of screen-based SB. There was also inconsistent evidence for physical activity buffering screen-based SB-internalizing symptom associations and for female sex amplifying screen-based SB-internalizing symptom associations. In general, the body of evidence for anxiety symptoms was more limited than that for depressive symptoms, and were therefore more inconsistent.

Conclusions

Screen-type, physical activity, and sex may influence the magnitude of screen-based SB-internalizing symptom coupling; highlighting potential sources of heterogeneity of screen-based SB-internalizing symptom associations. Additional studies aimed at understanding potential mechanistic explanations for the above moderators are needed prior to the development of tailored intervention strategies designed to decouple screen-based SB and internalizing symptoms among youth.

Associations between screen time, negative life events, and emotional and behavioral problems among Chinese children and adolescents

BACKGROUND

Mental health problems among children and adolescents are a pressing public health issue. This study aimed to investigate the associations between screen time (ST), negative life events (NLEs), and emotional and behavioral problems (EBPs) among Chinese children and adolescents.

METHODS

A total of 5959 boys and girls from 14 elementary and junior high schools of four cities in China were included in this study. EBPs were assessed by the Strengths and Difficulties Questionnaire (SDQ), NLEs were evaluated by the Adolescent Self-Rating Life Events Checklist (ASLEC), and ST data were obtained through self-reporting. Descriptive analyses, chi-squared tests, and logistic regression were performed using SPSS 23.0.

RESULTS

There were significant associations between ST/NLEs and EBPs. Participants with high exposure to ST or NLEs were more likely to have EBPs than those with low exposure to ST or NLEs. The simultaneous associations of ST and NLEs on EBPs were stronger than those of ST or NLEs, individually.

LIMITATIONS

This was a cross-sectional research study; therefore, it could not judge causality or direction. ST and NLEs were retrospective and might have recall biases.

CONCLUSIONS

Our results showed positive associations between ST, NLEs, and EBPs. The results indicate that interventions should be considered to decrease ST and NLEs for children and adolescents.

Lifestyle Habits Predict Academic Performance in High School Students: The Adolescent Student Academic Performance Longitudinal Study (ASAP)

This study aimed to determine if lifestyle habits could predict changes in cognitive control and academic performance in high school students using a longitudinal approach. One hundred and eighty-seven grade seventh to ninth students (mean age: 13.1 ± 1.0 years old) completed a 3-year prospective study. Lifestyle habits, cognitive control, and academic performance were assessed every year during the 3-year study. Results show that in female students, screen time measures were negatively correlated with academic performance and cognitive control. Furthermore, changes (Δs) in sleeping habits were associated with Δs in academic performance in both genders, whereas Δs in eating habits and in studying time were correlated with Δs in academic performance only in male students. Moreover, in female students, screen time, social media use, and eating habits measures seem to predict the variance in the Δs of cognitive control measures (r² between 8.2% and 21.0%), whereas, in male students, studying time, eating, and sleeping habits appear to explain the variance in the Δs of academic performance measures (r² between 5.9% and 24.8%). In conclusion, results of the present study indicate that lifestyle habits were able to predict Δs in cognitive control and academic performance of high school students during a 3-year period.

Associations of Sedentary Behavior with Physical Fitness and Academic Performance among Chinese Students Aged 8-19 Years

Background: Existing evidence regarding how time spent on various types of sedentary behavior (SB) in relation to physical fitness (PF) and academic performance (AP) in children and adolescents is limited. This cross-sectional study aimed to explore the associations of SB types with PF and AP among 8–19-year-old Chinese students. Methods: A total of 1164 students were recruited from five schools in Zhejiang province, China. Children’s SB was assessed by a valid questionnaire and AP was represented by scores on four courses. PF was measured by Chinese National Student PF Standard battery. The associations were assessed using linear mixed-effects models adjusted for age, school, grade, and class. Results: Students’ screen-based SB was observed to be negatively associated with PF in girls (p < 0.05). Screen-based SB was inversely associated with AP in both girls and boys (p < 0.001). The significant interaction between weekdays and weekends, and SB on AP was observed in girls (p < 0.001). On weekends, screen-based SB ≥ 6 h/day (<3 h/day as reference group) was significantly and negatively associated with AP (p < 0.01 for both sex). Conclusions: Longer screen-based SB, especially on weekends, was related to poorer AP in 8–19-year-old Chinese students. Our findings suggest that restrictions on any type of screen-based SB for leisure on weekends are beneficial to AP in Chinese students.

Association Between Screen Media Use and Academic Performance Among Children and Adolescents: A Systematic Review and Meta-analysis

IMPORTANCE

The health consequences of excessive screen media use in children and adolescents are increasingly being recognized; however, the association between screen media use and academic performance remains to be elucidated.

OBJECTIVES

To estimate the association of time spent on screen-based activities with specific academic performance areas in children and adolescents and to examine this association separately in these populations.

DATA SOURCES

MEDLINE, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and ERIC were searched from database inception through September 2018.

STUDY SELECTION

Cross-sectional studies of the association between time or frequency of screen media use and academic performance in children and adolescents were independently screened by 2 researchers. A total of 5599 studies, published between 1958 and 2018 from 23 countries, were identified.

DATA EXTRACTION AND SYNTHESIS

Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effects models were used to estimate the pooled effect size (ES).

MAIN OUTCOMES AND MEASURES

Academic performance areas included composite scores, language, and mathematics. Screen media measurements included time or frequency of computer, internet, mobile phone, television, video game, and overall screen media use.

RESULTS

In total, 58 cross-sectional studies (1.0%) of 5599 articles were included in the systematic review, of which 30 (52%) were included in the meta-analysis. The systematic review studies involved 480 479 participants aged 4 to 18 years, ranging from 30 to 192 000 people per study, and the meta-analysis studies involved 106 653 total participants, ranging from 70 to 42 041 people per study. Across studies, the amount of time spent on overall screen media use was not associated with academic performance (ES = -0.29; 95% CI, -0.65 to 0.08). Individually, television viewing was inversely associated with composite academic performance scores (ES = -0.19; 95% CI, -0.29 to -0.09), language (ES = -0.18; 95% CI, -0.36 to -0.01), and mathematics (ES = -0.25; 95% CI, -0.33 to -0.16). Video game playing was inversely associated with composite scores (ES = -0.15; 95% CI, -0.22 to -0.08). Subgroup analyses found that television viewing was inversely associated with language only in children (ES = -0.20; 95% CI, -0.26 to -0.15), whereas both television viewing (ES = -0.19; 95% CI, -0.30 to -0.07) and video game playing (ES = -0.16; 95% CI, -0.24 to -0.09) were inversely associated with composite scores only in adolescents.

CONCLUSIONS AND RELEVANCE

Findings from this study suggest that each screen-based activity should be analyzed individually for its association with academic performance, particularly television viewing and video game playing, which appeared to be the activities most negatively associated with academic outcomes. Education and public health professionals should consider supervision and reduction to improve the academic performance of children and adolescents exposed to these activities.

Digital media: Promoting healthy screen use in school-aged children and adolescents

Digital media are integrated into the everyday lives of children and adolescents, with potential benefits and risks for learning, mental and physical health, and for social life. This statement examines the cognitive, psychosocial, and physical effects of digital media on school-aged children and adolescents, with a focus on family routines, context, and activities. Evidence-based guidance for clinicians and families involves four principles: healthy management, meaningful screen use, positive modelling, and balanced, informed monitoring of screen time and behaviours.

Les médias numériques : la promotion d'une saine utilisation des écrans chez les enfants d'âge scolaire et les adolescents

Les médias numériques font partie du quotidien des enfants et des adolescents. Ils comportent des bienfaits potentiels et des risques pour leur apprentissage, leur santé mentale et physique et leur vie sociale. Le présent document de principes aborde les effets cognitifs, psychosociaux et physiques de ces médias sur les enfants d'âge scolaire et les adolescents, notamment sur les habitudes, le contexte et les activités de la famille. Les conseils fondés sur des données probantes destinés aux cliniciens et aux familles reposent sur quatre principes : une gestion saine, une utilisation constructive, un exemple positif et une surveillance équilibrée et éclairée du temps d'écran et des comportements s'y rapportant.

The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: a systematic review and meta-analysis

OBJECTIVE

The association between diet quality, dietary behavior and health-related quality of life has been mostly examined in children and adolescents with specific chronic diseases. No systematic review has synthesized the influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents. The purpose of this study was to systematically review the primary studies that evaluated the association between diet quality, dietary behavior and health-related quality of life in the general population of children and adolescents and to synthesize the findings for the association.

METHODS

A computer search in the databases of MEDLINE, EMBASE and PSYCINFO was performed to retrieve English language studies that were published from 1946 up to April 8, 2018. We also screened the PubMed-related articles and the reference lists of the existing relevant literature to identify other eligible studies. We synthesized the association between diet quality, dietary behavior and health-related quality of life using both a qualitative method and meta-analysis. We reported the review following up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline.

RESULTS

Seventeen studies were included in the synthesis including twelve cross-sectional studies and five longitudinal studies. We found that diet quality and dietary behavior were associated with health-related quality of life in children and adolescents. The positive effect of healthy diets on health-related quality of life was observed for multiple domains of health-related quality of life, including physical, school and emotional functioning, and psychosocial quality of life. We observed a dose-response relationship between the diet exposure and health-related quality of life, where an unhealthy dietary behavior or lower diet quality was associated with decreased health-related quality of life among children and adolescents.

CONCLUSION

The findings of the systematic review suggest the importance of promoting healthy diets and nutrition for good health-related quality of life among children and adolescents. Future research is needed to strengthen the evidence for prospective relationships and for the dose-response effect between diet quality, dietary behavior and health-related quality of life among children and adolescents.