Review
Systematic review of correlates of screen-viewing among young children

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Abstract

Objective

The aims of this review were to: (I) synthesise current research on the correlates of screen-viewing among young children (≤ 7 years old); and (II) identify gaps in the study of these correlates.

Methods

71 English-language studies published between 1980 and February 2009 were extracted from computerized literature searches and bibliographies of primary studies.

Results

Variables positively associated with screen-viewing were age, ethnicity, family TV viewing, family factors (maternal depressive symptoms and parental body mass) and media access. Variables negatively associated were socioeconomic indicators, parental rules and safety. Mother's age, mother's employment and presence of a TV set in a child's bedroom were found to be unclearly associated with screen-viewing behaviour. Gender, marital status, father's age and number of TVs were not associated with screen-viewing behaviour.

Conclusions

Few modifiable variables for future research implications were identified. Findings suggest that research on correlates of screen-viewing among young children is limited. However, there are some clear correlates on which future interventions could be tailored (age, ethnicity, some socioeconomic indicators, family TV viewing, some family factors, parental rules and safety). Subsequent research is needed both to further test some of the correlates and to review the correlates for strength of associations.

Introduction

Childhood obesity is increasing globally with 30.5% of UK (The Health and Social Care Information Centre, 2008) and 31.9% of US (Ogden et al., 2008) children and adolescents being overweight or obese. Obesity is a multi-factorial health problem influenced by metabolic, genetic, environmental, social and cultural factors. It is the result of an imbalance of energy intake and expenditure (Hill and Melanson, 1999). While the evidence of an association between screen-viewing and obesity is generally equivocal (Biddle et al., 2004, Marshall et al., 2004, Marshall et al., 2006, Rey-López et al., 2008), a number of longitudinal studies have reported an association between higher screen-viewing and obesity (Hancox & Poulton, 2006, Jago et al., 2005, Proctor et al., 2003, Viner & Cole, 2005). It is therefore important to identify the key correlates of screen-viewing and how they may be changed.

The mediating variable model suggests that in order to change behaviours such as screen-viewing, we need to understand the key mediators and moderators of the behaviours (Baranowski et al., 1998). Thus, in order to reduce screen-viewing, we need to understand the key factors that influence screen-viewing behaviours and how they may differ by participant characteristics such as age, gender or family circumstances. The majority of current studies and reviews have focused only on the description of sedentary activity habits or activity patterns and on associations with weight or other health outcomes. Moreover, most of these studies have focused on all youth (children and adolescents), when it seems unlikely that the factors that influence the screen-viewing of a 6-year-old will be the same as the factors that affect a 16-year-old.

To the best of our knowledge, no review has focused on the correlates of screen-viewing among young children (≤ 7 years of age). Early childhood is a key period of interest, because preschool years and middle childhood are potentially important transition periods and critical times for the formation of social skills, specifically learning to interact with others as well as learning to make choices, including those that influence physical activity (Shiner and Caspi, 2003) and screen-viewing behaviours (Janz et al., 2005). Furthermore, television viewing patterns may be shaped during the preschool years (Certain and Kahn, 2002) and patterns of screen-viewing at this age may track into later life (Hancox et al., 2004, Jago et al., 2005, Janz et al., 2005).

The aims of this review paper are to: (I) synthesise current research on the correlates of screen-viewing among young children aged ≤ 7 years old; and (II) identify gaps in the study of these correlates.

Section snippets

Methods

Published English-language studies were located using two methods. Firstly, PubMed, Cochrane Library, MedLine and PsycINFO databases were searched for studies published between 1980 and February 2009. The following keyword combinations were used: screen viewing children, TV children, computer children, video game children, sedentary children, sedentary lifestyle children, sedentary behaviour children, sedentary physical activity children and inactivity children. Secondly, reference sections of

Study characteristics

188 studies presented an empirical association between a screen-viewing behaviour and at least one correlate. 117 studies were excluded; 51 because they focused solely on weight status and 66 were age combined studies that did not report any correlates for ≤ 7 years old.

From the 71 studies included (see Fig. 1 and Table 1), 2.8% of the studies were published between 1980 and 1990 (n = 2), 11.2% between 1990 and 2000 (n = 8) and 86% after 2000 (n = 61). The majority of the designs (71.8%, n = 51) were

Key findings and significance

In this review we found few consistently modifiable sociocultural and environmental correlates. Identified modifiable correlates were family TV viewing, parental body mass, parental rules and media access. Demographic correlates (age, ethnicity and socioeconomic indicators) were consistently associated with higher screen-viewing.

In this review we found no association between the presence of a TV set in a child's bedroom, the number of TV sets in the household and screen-viewing. This is

Conclusions and recommendations

Demographic variables and some socio-cultural and environmental correlates appeared to be the most consistently correlated with young children's screen-viewing. Identified non-modifiable variables suggest subgroups that need to be targeted for intervention programs. Few modifiable sociocultural and environmental variables were identified, but these might reflect important findings and targets for future research. Although measurement and design limitations of the existing literature limit the

Conflicts of interest statement

The authors declare that there are no conflicts of interest.

Acknowledgments

This report is research arising from a Career Development Fellowship (to Dr. Jago) supported by the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

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