A Research On Associations Between Screen Time And Schoolchildren's Physical-mental Health During Different Developmental Stages

Objective To further explore the associationbetween screen time and physical-mental health on schoolchildren during different developmental stages,according to the description of distribution characteristics on screen time in different developmental stages.Methods With informed consent,childrenin grade 1 and 2 from2 primary schools in Bengbu cityand their parents are invited to participate.The average daily screen time in early childhood(0 ~ 3 years old),preschool(3 ~ 6 years old)and currentweekdays and weekends(school age)are collected from parents' questionnaire survey.Internalizing and Externalizing Problem is assessed by Strengths and Difficulties Questionnaire(SDQ).Executive functionis assessed by Behavior Rating Inventory of Executive Function-Preschool(BRIEF-P).Score of behavioral regulation index(BRI),meta-cognition index(MI)and global executive composite(GEC)are evaluated.Body mass index(BMI)is calculated based on physical examination.To evaluate the distribution of visual time at different developmental stages in different demographic characteristics,and?2 test isapplied to evaluate the related influencing factorsofscreen timeduring different developmental stages,BMI,psychology and behavior problems,executive function in children.Linear regression and logistics regression are used to explore respectively the associationsnot only between screen time duringdifferent developmental stages and BMI,but also between psychological behavioral problems and executive function indexes.Results A total of 1,269 complete parents' questionnaires are collected.Parents indicate that children's screen time increases with age,the screen time of infants is 0h/d,the highest proportion reaches 20.1% in all developmental stages.About 13.1%and24.5%of children have1~2h/dscreen time during early childhood and preschool period,with 4.3%and 8.4% have ?2h/d,respectively.The screentime of weekdays is significantly lower than weekends.17.9%of childrenare exposed to screen time 0h/d on weekdays,significantly higher than1.9%of childrenare 0h/don weekends.The screentime of weekdays is significantly lower than weekends.15.6%of childrenare exposed to screen time?2h/d on weekdays,significantly lower than 74.2%of children on weekends.Screen time >1h/d in infancy is related to poor self-assessment on health condition at school age,and PA>90 minutes every day.Screen time > 1h/d at preschool age is related to fathers' higher education background(beyond high school education),poor academic records,and PA > 90 minutes every day.For school age students,Concerning screen time at weekdays and weekends,boys account for higher proportion than girls.Meanwhile,the proportion of the screen time,as for those mothers' higher education attainment(beyond bachelor degree),is below that of mother's lower education attainment(at middle school or below).Overweight children and obesity rate account for respectively 14.7% and 11.5%.Multivariate logistic regression analysis shows that for school age children screen time at weekdays are negatively correlated with BMI(B=-0.0,95% CI:-0.17~0.05),while screen time at weekends is positively correlated with BMI(B=0.29,95% CI:0.10~0.49).Regarding Internalizing behaviors,externalizing behaviors and anomalous total difficulties,the detectable rates are respectively 1.2%,0.6% and2.8%.Multivariate logistic regression analysis shows that for preschool children screen time is positively correlated with internalizing behaviors(B=0.35,95% CI:0.14~0.56),externalizing behaviors(B=0.19,95% CI:0.01~0.37),and total difficulties(B=0.53,95% CI:0.17~0.89).Combined with screen time during different developmental stages,Multivariate logistic regression analysis shows that screen time in infancy is positively correlated with BRIT(B=0.54,95% CI:0.11~0.97),MIT(B=0.63,95% CI: 0.04~1.22)and GECT(B=0.61,95%CI: 0.07~1.14).Meanwhile,screen time at preschool period is positively correlated with BRIT(B=0.78,95% CI:0.27~1.30),MIT(B=1.68,95% CI : 0.96~2.39)and GECT(B=1.46,95% CI:0.81~2.11).Furthermore,screen time at weekends is positively correlated with MIT(B=0.91,95% CI:0.10~1.73),and GECT(B=0.95,95% CI :0.20~1.69).Multivariate logistic regression analysis shows that compared with the no screen time group in early childhood,those who have screen time < 0.5 h/d,0.5 ~ 1h/d,1 ~ 2h/d and ?2h/d have significantly higher BRIT [OR(95% CI)] : 1.880(1.192 ~2.963),1.894(1.154 ~ 3.108),2.125(1.193 ~ 3.783)and 3.110(1.421 ~ 6.807),(P<0.05)].In the group who have screen time 0.5 ~ 1h/d and ?2h/d have significantly higher GECT [OR(95% CI): 1.776(1.106 ~ 2.854)and 2.344(1.071 ~ 5.132),(P <0.05)].Compared with the group who have screen time < 0.5h/d in preschool,those who have screen time 0.5 ~ 1h/d,1 ~ 2h/d and ?2h/d have significantly higher BRIT [OR(95% CI): 1.828(1.194 ~ 2.798),2.304(1.407 ~ 3.773),2.293(1.176 ~ 4.468),(P<0.05)].In the group who have screen time 1~2h/d have significantly higher MIT [OR(95% CI): 2.036(1.264 ~ 3.280)(P < 0.05)].And who have screen time 0.5~1h/d?1~2h/d and ?2h/d have significantly higher GECT [OR(95% CI): 1.640(1.075 ~ 2.503),2.304(1.416 ~ 3.750)and 2.109(1.086 ~ 4.099)(P< 0.05)].Conclusion Children's screen time increases with age.The screen time of infants is0h/d,which accounts for higher proportion.Screen time at preschool period increases more than that in infancy,while screen time at weekends raises higher than that at weekdays.It is common existence for school age students that screen time i over 2h/d.Concerning school age students,screen time at weekdays is negatively correlated with internalizing behaviors and BMI,while screen time at weekends is positively correlated with BMI.Screen time at preschool period is positively correlated with internalizing behaviors,externalizing behaviors and total difficulties.Screen time during infancy preschool period are positively correlated with BRI,MI and GEC.Referring to school age children,screen time at weekends is positively correlated with MI and GEC.When it is over 0.5 h for screen time during infancy and preschool period,it will decrease executive functional indexes.Screen time leads to bad effects to children's psycho-mental health.