Jin Zhao1, Yunting Zhang2, Fan Jiang3, Patrick Ip4, Frederick Ka Wing Ho4, Yuning Zhang5, Hong Huang6. 1. Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Child Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Child Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 3. Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China. 4. Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong. 5. Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom. 6. Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: huanghong@smhb.gov.cn.
Abstract
OBJECTIVES: To examine the relationship between excessive screen time and psychosocial well-being in preschool children, and the potential mediating role of body mass index, sleep duration, and parent-child interaction. STUDY DESIGN: A cross-sectional survey was conducted in Shanghai, China using stratified random sampling design. A representative sample of 20 324 children aged 3-4 years old from 191 kindergartens participated in this study. Parents completed the Strengths and Difficulties Questionnaire and reported the child's time spent on screen exposure, sleep duration, height, weight, and parent-child interactive activities. RESULTS: Preschool children in Shanghai were exposed to 2.8 (95% CI 2.7, 2.9) hours/day of screen time, with 78.6% (95% CI 77.8,79.3) exceeding 1 hour/day and 53% (95% CI 52.0,53.9) exceeding 2 hours/day. Every additional hour of screen time was associated with increased risk for poor psychosocial well-being. Body mass index, sleep duration, and parent-child interaction mediated the effect of excessive screen time on children's psychosocial well-being, among which parent-child interaction contributed most. Parent-child interaction could explain 28.1% of the effect on total difficulties and 58.6% on prosocial behavior. CONCLUSIONS: Excessive screen time during early childhood exists in Shanghai preschool children. Excessive screen exposure was associated with poor psychosocial well-being in preschool children via a number of mediators, mostly by reducing parent-child interaction.
OBJECTIVES: To examine the relationship between excessive screen time and psychosocial well-being in preschool children, and the potential mediating role of body mass index, sleep duration, and parent-child interaction. STUDY DESIGN: A cross-sectional survey was conducted in Shanghai, China using stratified random sampling design. A representative sample of 20 324 children aged 3-4 years old from 191 kindergartens participated in this study. Parents completed the Strengths and Difficulties Questionnaire and reported the child's time spent on screen exposure, sleep duration, height, weight, and parent-child interactive activities. RESULTS: Preschool children in Shanghai were exposed to 2.8 (95% CI 2.7, 2.9) hours/day of screen time, with 78.6% (95% CI 77.8,79.3) exceeding 1 hour/day and 53% (95% CI 52.0,53.9) exceeding 2 hours/day. Every additional hour of screen time was associated with increased risk for poor psychosocial well-being. Body mass index, sleep duration, and parent-child interaction mediated the effect of excessive screen time on children's psychosocial well-being, among which parent-child interaction contributed most. Parent-child interaction could explain 28.1% of the effect on total difficulties and 58.6% on prosocial behavior. CONCLUSIONS: Excessive screen time during early childhood exists in Shanghai preschool children. Excessive screen exposure was associated with poor psychosocial well-being in preschool children via a number of mediators, mostly by reducing parent-child interaction.
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