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Screen-Time and Health in Children and Adolescents

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 34627

Special Issue Editors

Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA
Interests: pediatric health; motor development; physical activity; childhood obesity; screen-time; policy
Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
Interests: childhood obesity; e-/mHealth; physical activity; exergames; telehealth; screen-time

Special Issue Information

Dear Colleagues,

This Special Issue invites contributions from across the spectrum of health (psychological, behavioral, and physiological) to examine the relationship between screen-time and health in children and adolescents. Children and adolescents are spending an increasing amount of their time using screen-based devices. Screens serve a variety of functions for youth, ranging from a sedentary, entertainment pastime to a way to interact with friends and family, play games, connect to educational programs or seek information, communicate with healthcare providers, engage in physical activity, among others. Previous literature has focused on the impact of the duration of screen-time on psychological, behavioral, and health factors including obesity, nutrition, academic outcomes, depressive symptoms, social-emotional delays, executive functioning, and motor skills. More work is needed to investigate if there are differential effects of screens based on the modality or platform, if there are potential positive implications to screen usage (e.g., through mHealth interventions and eLearning platforms), and to what degree screens may pose a risk to children.

This Special Issue is open to original research, review articles, short reports, brief commentaries, case reports, and meta-analyses related to screen-time and a myriad of health outcomes. This Special Issue aims to investigate the intersection of screen-time and health in children and adolescents, allowing both observational data (with a preference for longitudinal cohorts) as well as interventions designed to alter screen usage, deliver health information, or shape health behaviors via screens. We hope to attract studies that investigate a wide range of health behaviors to better understand the diverse role screens play in the health and development of children and adolescents.

Dr. E. Kipling Webster
Dr. Amanda Staiano
Prof. Dr. Michael J. Duncan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • screen-time
  • child health
  • adolescent health
  • physical activity
  • nutrition
  • obesity
  • exergaming
  • television
  • social media
  • eHealth
  • mHealth

Published Papers (10 papers)

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Research

11 pages, 595 KiB  
Article
Do Animations Impair Executive Function in Young Children? Effects of Animation Types on the Executive Function of Children Aged Four to Seven Years
Int. J. Environ. Res. Public Health 2022, 19(15), 8962; https://doi.org/10.3390/ijerph19158962 - 23 Jul 2022
Cited by 1 | Viewed by 1714
Abstract
This study used a three (animation types: educational, entertainment, and control groups) × four (age group: four-, five-, six-, and seven-year-olds) between-group experimental design to investigate the short-term effects of animation type and age on each component of children’s executive function (EF) (inhibitory [...] Read more.
This study used a three (animation types: educational, entertainment, and control groups) × four (age group: four-, five-, six-, and seven-year-olds) between-group experimental design to investigate the short-term effects of animation type and age on each component of children’s executive function (EF) (inhibitory control [IC], cognitive flexibility [CF], and working memory [WM]). One hundred twenty-six kindergarten and first-grade elementary school students in a city in Henan Province of China were selected for the experimental study. The results showed that briefly watching animation affected children’s EF. Specifically, watching entertainment cartoons weakened children’s IC and CF, while cartoons did not affect children’s WM. The moderating effect of age in the relationship between animation type and EFs was non-significant. This study suggests that researchers should focus on the uniqueness of each component of EF in children aged four to seven years, and parents should try to limit children’s viewing of animation, especially entertainment animation. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
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11 pages, 330 KiB  
Article
Determinants of Excessive Screen Time among Children under Five Years Old in Selangor, Malaysia: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2022, 19(6), 3560; https://doi.org/10.3390/ijerph19063560 - 17 Mar 2022
Cited by 9 | Viewed by 3728
Abstract
Excessive screen time interferes with the health and development of children. However, the screen time situation among Malaysian children remains poorly understood. This study aims to identify the prevalence and determinants of excessive screen time among children under five years in Selangor, Malaysia, [...] Read more.
Excessive screen time interferes with the health and development of children. However, the screen time situation among Malaysian children remains poorly understood. This study aims to identify the prevalence and determinants of excessive screen time among children under five years in Selangor, Malaysia, using the latest World Health Organization guidelines. In this cross-sectional study, 489 parent–child dyads were randomly selected from nine government health clinics in Petaling district, Selangor. Total screen time and factors were assessed using validated self-administered questionnaires and analysed using multiple logistic regression. The overall prevalence of excessive screen time was 91.4% with a median of 3.00 h. The majority of children utilized television (66%), followed by handheld devices (30%) and computers (4%). Determinants of screen time identified were Malay ethnicity, (aOR 3.56, 95% CI 1.65–7.68), parental age of ≥30 years (aOR 3.12, 95% CI 1.58–6.16), parental screen time >2 h a day (aOR 2.42, 95% CI 1.24–4.73), moderate self-efficacy to influence a child’s physical activity (aOR 2.29, 95% CI 1.01–5.20) and the positive perception on the influence of screen time on a child’s cognitive wellbeing (aOR 1.15, 95% CI 1.01–1.32). Parents play an important role in determining their child’s screen time. Future interventions should focus on addressing parental determinants to ensure age-appropriate screen time. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
13 pages, 601 KiB  
Article
Influences of Smartphone and Computer Use on Health-Related Quality of Life of Early Adolescents
Int. J. Environ. Res. Public Health 2022, 19(4), 2100; https://doi.org/10.3390/ijerph19042100 - 13 Feb 2022
Cited by 6 | Viewed by 2205
Abstract
This study explored the daily amount of time that early adolescents spent using smartphones and computers, and their influences on health-related quality of life of early adolescents. A total of 650 early adolescents were recruited. The 36-Item Short Form Health Survey was used [...] Read more.
This study explored the daily amount of time that early adolescents spent using smartphones and computers, and their influences on health-related quality of life of early adolescents. A total of 650 early adolescents were recruited. The 36-Item Short Form Health Survey was used to measure their health-related quality of life. The early adolescents reported their average daily time spent using smartphones and computers over the course of the previous week; the majority of early adolescents (71%) spent approximately 1 h a day or less using computers on average or reported no computer use, and 98.8% indicated that they used smartphones for less than 1 h to more than 4 h per day on average. The results showed that the average daily time spent using smartphones was significantly negatively associated with two scales in the physical domain and four scales in the mental domain of health-related quality of life of early adolescents, whereas the average daily time spent using computers was significantly negatively associated with two scales in the mental domain (p < 0.05). Therefore, early adolescents who spent more time using smartphones and computers have significantly poorer outcomes in the physical and mental domains of their health-related quality of life. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
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13 pages, 890 KiB  
Article
Association of Night-Time Screen-Viewing with Adolescents’ Diet, Sleep, Weight Status, and Adiposity
Int. J. Environ. Res. Public Health 2022, 19(2), 954; https://doi.org/10.3390/ijerph19020954 - 15 Jan 2022
Cited by 4 | Viewed by 2249
Abstract
Night-time screen-viewing (SV) contributes to inadequate sleep and poor diet, and subsequently excess weight. Adolescents may use many devices at night, which can provide additional night-time SV. Purpose: To identify night-time SV patterns, and describe differences in diet, sleep, weight status, and adiposity [...] Read more.
Night-time screen-viewing (SV) contributes to inadequate sleep and poor diet, and subsequently excess weight. Adolescents may use many devices at night, which can provide additional night-time SV. Purpose: To identify night-time SV patterns, and describe differences in diet, sleep, weight status, and adiposity between patterns in a cross-sectional and longitudinal manner. Methods: Adolescents (10–16 y) reported devices they viewed at night and completed food recalls. Accelerometry, anthropometrics, and imaging were conducted to measure sleep, weight status, and adiposity, respectively. Latent class analysis was performed to identify night-time SV clusters. Linear regression analysis was used to examine associations between clusters with diet, sleep, weight status, and adiposity. Results: Amongst 273 adolescents (12.5 ± 1.9 y, 54% female, 59% White), four clusters were identified: no SV (36%), primarily cellphone (32%), TV and portable devices (TV+PDs, 17%), and multiple PDs (17%). Most differences in sleep and adiposity were attenuated after adjustment for covariates. The TV+PDs cluster had a higher waist circumference than the no SV cluster in cross-sectional analysis. In longitudinal analysis, the primarily cellphone cluster had less change in waist circumference compared to the no SV cluster. Conclusions: Directing efforts towards reducing night-time SV, especially TV and PDs, may promote healthy development. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
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14 pages, 363 KiB  
Article
Effects of Parental Involvement in a Preschool-Based Eye Health Intervention Regarding Children’s Screen Use in China
Int. J. Environ. Res. Public Health 2021, 18(21), 11330; https://doi.org/10.3390/ijerph182111330 - 28 Oct 2021
Cited by 5 | Viewed by 3641
Abstract
In this digital era, young children spend a considerable amount of time looking at telephone, tablet, computer and television screens. However, preventative eye health behavior education could help avoid and relieve asthenopia. The effects of parental influence on their children’s eye health behavior [...] Read more.
In this digital era, young children spend a considerable amount of time looking at telephone, tablet, computer and television screens. However, preventative eye health behavior education could help avoid and relieve asthenopia. The effects of parental influence on their children’s eye health behavior through the preschool eye health education intervention program were examined. The Health Belief Model was used to develop parental involvement strategy and eye health curriculum. The study was conducted in a large public preschool with five branches in Beijing, China. A total of 248 parent–child pairs participated in the baseline and follow-up surveys, of which 129 were in the intervention group and 119 were in the comparison group. The generalized estimating equation analysis results indicated that parental involvement in preschool-based eye health intervention on screen uses had positive influence on parents’ eye health knowledge, cues to action, and parenting efficacy. The intervention program also had positive effects on the increasing level of children’s eye health knowledge, beliefs, cues to action, self-efficacy, and behaviors. The results supported the implementation of a preschool-based eye health intervention program with parental involvement, which could potentially enhance children’s and parents’ eye health beliefs and practices. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
12 pages, 349 KiB  
Article
The Relationships of Watching Television, Computer Use, Physical Activity, and Food Preferences to Body Mass Index: Gender and Nativity Differences among Adolescents in Saudi Arabia
Int. J. Environ. Res. Public Health 2021, 18(18), 9915; https://doi.org/10.3390/ijerph18189915 - 21 Sep 2021
Cited by 10 | Viewed by 3344
Abstract
Background: Adolescents and ethnic subgroups have been identified at high risks of overweight and its associated complications. Although some studies have investigated overweight, obesity, nutritional status, physical activity, and associated factors among Saudi students, no studies have examined these characteristics among non-Saudi students [...] Read more.
Background: Adolescents and ethnic subgroups have been identified at high risks of overweight and its associated complications. Although some studies have investigated overweight, obesity, nutritional status, physical activity, and associated factors among Saudi students, no studies have examined these characteristics among non-Saudi students or compared non-Saudi to Saudi adolescent students. The objective of this study was to compare differences between Saudi and non-Saudi adolescent students regarding time spent watching television, using computers, engaging in physical activity, and their food preferences. The relationships between these lifestyle behaviors and body mass index by Saudi nativity and gender were tested. Methods: Students aged 12 to 18 years (n = 214) from various schools in Riyadh, Saudi Arabia, completed a self-administered questionnaire that included questions about demographic and anthropometric characteristics, daily after-school routine, physical activity, watching television, using computers, and food preferences. Non-parametric (Mann–Whitney U) tests assessed the statistical differences between Saudi and non-Saudi respondents, and males and females were separately tested. Results: Saudi boys who reported physical activity two to five times per week, the most television time, the most computer time, and the highest frequency of eating fast food and drinking soft drinks had a significantly higher mean body mass index than the non-Saudi boys in their categories. However, there were no significant differences found between the Saudi and non-Saudi girls. Conclusions: High levels of sedentary and low levels of physical activities as well as high consumption of high-fat fast foods and high-sugar drinks threaten the health of Saudi adolescents. Cultural differences in lifestyle between Saudi and non-Saudi families should be considered when developing programs to improve knowledge, attitudes, and behaviors regarding diet quality and physical activity. The objective of this study is more important in the current situation where increased time spent on computers and mobile phones due to online teaching in schools or working from home, decreased physical activity due to precautionary lockdowns, and unchecked eating patterns while spending more time in sedentary activities in homes has become our COVID-19 pandemic lifestyle in all the age groups. A similar study should be replicated on a large scale to study the effect of this lifestyle on our lives in all the age groups. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
14 pages, 372 KiB  
Article
The Differential Impact of Screen Time on Children’s Wellbeing
Int. J. Environ. Res. Public Health 2021, 18(17), 9143; https://doi.org/10.3390/ijerph18179143 - 30 Aug 2021
Cited by 3 | Viewed by 4450
Abstract
Increased screen time has been found to be associated with a number of negative health and wellbeing indicators in youth populations. An increasing number of studies have investigated the association between screen time and wellbeing in adolescents, but evidence in younger children is [...] Read more.
Increased screen time has been found to be associated with a number of negative health and wellbeing indicators in youth populations. An increasing number of studies have investigated the association between screen time and wellbeing in adolescents, but evidence in younger children is still emerging. This 2017 study explored the effect of leisure screen time and gender on dimensions of wellbeing (measured using KIDSCREEN-27) in a national sample of 897 Irish primary school children aged 8–12 years. Participants had a mean age of 10.9 ± 1.16 years and were 47.7% female. Just over 30% of the sample accumulated 2 h or more of leisure screen time daily. Results show that there was no significant interaction between screen time category (<2 h/2 h + daily) and gender on overall wellbeing, while controlling for BMI. Children who self-reported <2 h of leisure screen time scored significantly higher on four dimensions of wellbeing: physical, parental, peers, and school, but not psychological. This study supports the growing evidence of the impact that leisure screen time has on health. Further longitudinal research investigating the impact of sub-categories of leisure screen time behaviour on wellbeing is warranted. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
13 pages, 1082 KiB  
Article
Electronic Games, Television, and Psychological Wellbeing of Adolescents: Mediating Role of Sleep and Physical Activity
Int. J. Environ. Res. Public Health 2021, 18(16), 8877; https://doi.org/10.3390/ijerph18168877 - 23 Aug 2021
Cited by 4 | Viewed by 3225
Abstract
This study investigated the associations between two common recreational screen activities and the psychological wellbeing of adolescents, and whether this association was mediated by sleep duration or physical activity frequency. This study used nationally representative cross-sectional survey data from 2946 adolescents (mean age [...] Read more.
This study investigated the associations between two common recreational screen activities and the psychological wellbeing of adolescents, and whether this association was mediated by sleep duration or physical activity frequency. This study used nationally representative cross-sectional survey data from 2946 adolescents (mean age 16.9 [0.38] years; 49% female) in the Longitudinal Study of Australian Children (LSAC). Adolescents provided information on daily time spent for each of the following: playing electronic games and watching television, time of sleep onset and wakeup, and number of days/week doing ≥60 min/day of physical activity. Psychological wellbeing was assessed by the Strengths and Difficulties Questionnaire (SDQ). Generalized estimating equations were used to examine the associations, and a contemporary multiple mediation analysis was used to examine the mediation effects. One fifth (20%) of adolescents were categorized as having poor wellbeing (SDQ total ≥17) with a significant sex difference (males: 16%; females: 24%; p < 0.001). Playing electronic games was inversely associated with psychological wellbeing for both male and female adolescents (p < 0.001). Watching television was inversely associated with psychological wellbeing for female adolescents (p < 0.001). Sleep duration and physical activity frequency were found to partially mediate the relationships between playing electronic games and the psychological wellbeing of male and female adolescents. Physical activity frequency partially mediated the association between television watching and wellbeing among female adolescents. Longitudinal studies are required to determine the causal pathway between screen-based activities and the wellbeing of adolescents, and to inform intervention strategies. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
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12 pages, 564 KiB  
Article
The Short-Term Impact of Animation on the Executive Function of Children Aged 4 to 7
Int. J. Environ. Res. Public Health 2021, 18(16), 8616; https://doi.org/10.3390/ijerph18168616 - 15 Aug 2021
Cited by 3 | Viewed by 2978
Abstract
Research has shown that animation plays an important role in the development of children’s executive function (EF), and the development of EF components, inhibitory control, working memory, and cognitive flexibility, is asynchronous. Thus, this study explores the developmental trajectories and animation features (fantasy [...] Read more.
Research has shown that animation plays an important role in the development of children’s executive function (EF), and the development of EF components, inhibitory control, working memory, and cognitive flexibility, is asynchronous. Thus, this study explores the developmental trajectories and animation features (fantasy and pacing) that influence each EF component, by examining 218 children aged 4–7. Pretest information, mainly the childhood EF inventory, was provided by parents: child’s age, age of first exposure to animation, animation viewing time on weekdays and weekends, family income, and parents’ education. The children in each age group were randomly divided into four groups to watch animations comprised of different animation features. After watching, their EF were measured by a day-night task, backward digit-span task, and flexible item-selection task. The results showed that the children’s inhibitory control, working memory and cognitive flexibility levels all improved with age. Highly fantastical animations weakened children’s performance on each subsequent EF task. Pacing had no effect on any of the components of children’s EF. An interactive effect on inhibitory control was only found with fantasy in younger children; specifically, high-fantastical animations had a more pronounced short-lived weakening effect on inhibitory control in younger children (4–6 years) compared with low-fantastical animations. Future research should explore the long-term impact of content rather than the form of animation on younger children’s EF. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
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12 pages, 575 KiB  
Article
A Network Perspective on the Relationship between Screen Time, Executive Function, and Fundamental Motor Skills among Preschoolers
Int. J. Environ. Res. Public Health 2020, 17(23), 8861; https://doi.org/10.3390/ijerph17238861 - 28 Nov 2020
Cited by 16 | Viewed by 5084
Abstract
The present study aimed to analyze the dynamic and nonlinear association between screen time, executive function (EF), and fundamental motor skills (FMS) in preschoolers, considering sex and body mass index (BMI) from a network perspective. Forty-two preschoolers (24 boys, 3.91 ± 0.77 years [...] Read more.
The present study aimed to analyze the dynamic and nonlinear association between screen time, executive function (EF), and fundamental motor skills (FMS) in preschoolers, considering sex and body mass index (BMI) from a network perspective. Forty-two preschoolers (24 boys, 3.91 ± 0.77 years old) provided screen time, EF, FMS, and BMI data. EF was measured using the Go/No Go task, and accuracy of Go (sustain attention), reaction time of Go, and accuracy of No Go (inhibitory control) were considered. Relationships between screen time, EF, FMS, sex, and BMI were explored using a network analysis. The emerged network highlights that screen time is intensely associated with the other variables in the network, while the accuracy of Go has the greater connectivity with other nodes in the network (2.27), being the most sensitive to potential intervention changes. Moreover, sex (1.74), screen time (0.93), and accuracy of Go (0.71) showed the greatest closeness. This study showed that in the emerged network, independent of sex, screen exposure affects the accuracy on Go task, and these components affect the variables in the network, as motor abilities and tasks involved in inhibitory control. Full article
(This article belongs to the Special Issue Screen-Time and Health in Children and Adolescents)
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