Feasibility of two screen media reduction interventions: Results from the SCREENS pilot trial

Background Advancements in screen media devices has transformed the way families engage with screen media. Although these modern devices offer many opportunities, e.g. communication and research online, an in-depth understanding of how these devices affect our health, is lacking. Before a definite randomized controlled trial, the SCREENS pilot study was conducted to assess compliance to and feasibility of two interventions, a measurement protocol, and a survey-based recruitment strategy. Also, the potential of the interventions to impact leisure time spent non-sedentary in children six-to-ten years of age was explored. Methods Families (N = 12) were recruited through a population-based survey sent out in October of 2018 to adults (N = 1,675) in the Municipality of Middelfart, Denmark. Families were randomized to one of two two-week interventions; an Evening Restriction intervention (no screen media use after six pm) and a General Restrict intervention (limit entertainment-based screen media to three hours/week/person). Intervention compliance was assessed objectively by measuring household TV usage, smartphone and tablet activity via an application, and via screen media diaries. During baseline and follow-up, as part of larger protocol, family members wore two triaxial accelerometers for seven consecutive days. The potential of the interventions to impact non-sedentary time was explored based on means and standard errors (SEs). Results Despite almost 85% and 75% reductions in leisure screen media use 0% and 50% of families were compliant in the Evening Restrict group and General Restrict group, respectively, based on strict a priori criteria. Participant feedback indicated that the General Restrict intervention generally was feasibly. Compliance to the accelerometry wear protocol was high (median non-wear was <1 hour/week). Moreover, the recruitment strategy was implemented and was feasible. The General restrict intervention might increase children’s non-sedentary time (mean (SE): 36.6 (23) min/day, N = 6). Conclusions The General Restriction intervention, the accelerometer wear protocol and recruitment strategy, appeared feasible. Trial registration NCT03788525 at https://clinicaltrials.gov [Retrospectively registered; 27th of December, 2018].

Measuring Parental Behavior towards Children’s Use of Media and Screen-Devices: The Development and Psychometrical Properties of a Media Parenting Scale for Parents of School-Aged Children

Children’s excessive screen use is associated with health risks such as obesity, sleep problems, attention problems, and others. The effect of parental regulative efforts focused on screen/media use (media parenting) is currently unclear and difficult to examine given the heterogeneity of measuring tools used for its assessment. We aimed to develop an inventory that would enable reliable and valid measurement of media parenting practices (especially active and restrictive mediation) in parents of primary school children. The inventory builds on existing tools, it is comprehensive, yet easy to use in research setting. The original MEPA-36 (36 items) and revised MEPA-20 (20 items) inventories were examined using data from 341 Czech and Slovak parents of children aged between 6 and 10 years. Psychometrical properties were estimated using confirmatory factor and reliability analyses. Model fit was better for MEPA-20 and similar to other currently available tools. Both active and restrictive mediation subscales demonstrated high internal consistency. The internal consistency of newly constructed risky mediation subscales (risky active, risky restrictive, and over-protective mediation) was low. MEPA-20, especially active and restrictive mediation subscales, can be recommended for research on media parenting in context of screen/media use of school-aged children.

Parental Self-Efficacy—A Predictor of Children's Health Behaviors? Its Impact on Children's Physical Activity and Screen Media Use and Potential Interaction Effect Within a Health Promotion Program

Insufficient physical activity (PA) and increased screen media use (SMU) can have detrimental effects on children's health. Parental self-efficacy (PSE) can act as an important predictor for a healthy upbringing. The aim of this study was to investigate the influence of PSE on children's PA and SMU. Additionally, a moderating effect of PSE on the intervention effect of the health promotion program “Join the Healthy Boat” was examined. Using a prospective randomized controlled trial, 558 kindergarten children (3.6 years [SD = 0.6]) were examined. Data was collected using parental self-report. A significant influence of PSE on children's PA (B = 0.33, p = 0.025) and children's SMU (B = 0.42, p = 0.006) was found. The moderating effect of PSE on the intervention effect was neither significantly related to children's PA (p = 0.360) nor to children's SMU (p = 0.531). This confirms the importance of PSE on children's health development. Despite the lack of a moderating effect, interventions should also promote healthy activity behaviors and self-efficacy for parents in order to engage children in a healthy lifestyle.

The Home Screen Media Environment of Saudi Toddlers

The past few years have witnessed a rapid increase in the use of screen media by adults and children alike. Despite the widespread use of technology in Saudi Arabia, previous findings on Saudi children’s screen media use have been inconsistent and contradictory. The current study provides a comprehensive picture of screen media use among young children in Saudi Arabia. It explored the home screen media environment of 220 children aged 1 to 3 years, whose primary caregivers completed an online survey. Findings showed that the vast majority of these children had started using screens before the age of 2 years. On average, Saudi toddlers watched television for about 2 hours a day and used mobile media devices for about 1 hour a day. Their overall screen time was about 3 hours a day. Results also indicated that media use rates among Saudi toddlers are higher than those reported in the United States and the United Kingdom. The most viewed content genre on mobile media was children’s songs. Understanding children’s patterns of media use is an important first step in guiding the development of research-driven recommendations for all stakeholders on the use of screen media by young children.

Impact of the COVID-19 lockdown on screen media use in patients referred for ADHD to child and adolescent psychiatry: an introduction to problematic use of the internet in ADHD and results of a survey

The COVID-19 outbreak and lockdown have been associated with multiple consequences for mental health, including an excessive and potentially harmful increase in screen media use. The specific consequences for children, adolescents and young adults with ADHD are still unknown. In the first part of this study, a short review of problematic use of the internet (PUI) in ADHD is presented, showing that patients with ADHD are at risk for different aspects of PUI, such as excessive gaming or problematic social media use. In the second part, we report original data of an online survey on screen media use before, during and after the lockdown completed by parents of children and adolescents clinically referred for ADHD. Parents rated children’s/adolescents’ media-related behavior and media time on a new screening questionnaire for PUI. Each item was rated three times, referring to the observed behavior before, during and 1–2 months after the lockdown. N = 126 parents of patients referred for ADHD aged 10–18 years participated in the study. Total media time increased by 46% during the lockdown and did not completely return to pre-Corona levels afterwards. Patients with difficulties concentrating, high irritability or deterioration of ADHD problems under lockdown spent more time with screen media than those with milder or no such problems. While the effects of the lockdown on screen media use and its negative impact on everyday life appear to be largely reversible, a small proportion of patients with ADHD apparently continue to show increased media use.

Night-time Screen Media Use in the Pediatric Intensive Care Unit

This prospective observational study quantified screen media use within the night-time pre-sleep period in a pediatric intensive care unit and postulated possible implications. Seventy-five patients between the ages of newborn to 19 years old were observed 5 evenings per week for 3 weeks. Trained observers documented the patient’s screen use, type of screen used, screen engagement, sleep state, light level, and parental presence. Patients in the ICU had on average 65 minutes of screen media use, per evening. The total screen media use averaged 59 minutes for the 0 to18-month age group; 83 minutes for the 18 to 24-month age group; 66 minutes for 2 to 6 year olds; 72 minutes for 6 to 13 year olds; and 74 minutes for those above 13. This research demonstrates that children are engaging in more screen time during the night hours than is recommended by the AAP.