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Risk factors and discrimination model for screen exposure among children under 3 years: findings from Fujian province
Chong Guo1, Jingmin Guo1, Zhi Qu2,3
1Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Rd. Gulou Dist, Fuzhou, Fujian, 350005, China.
Insights
Screen time guideline compliance is adequate for young children in Fujian, China, but alarmingly low for 1-2 year olds. Targeted interventions are crucial for this age group to improve adherence to healthy screen habits.
Area of Science:
- Pediatrics
- Public Health
- Child Development
Background:
- Global screen time guideline adherence is low, with limited data from China.
- This study addresses the prevalence of screen time guideline compliance in children under three in Fujian Province, China.
Purpose of the Study:
- Investigate screen time guideline compliance prevalence in children under 3 in Fujian, China.
- Identify risk factors and their independent effects on compliance.
- Develop a risk discrimination model for targeted interventions.
Main Methods:
- Cross-sectional survey of 4,707 low-income families in urban and rural Fujian.
- Face-to-face interviews collected sociodemographic, lifestyle, and screen media data.
- Multivariable logistic regression and ROC curve analysis (AUC) identified risk factors and model performance.
Main Results:
- Compliance rates: 56.8% (under 1 yr), 18.8% (1-2 yrs), 81.9% (2-3 yrs).
- Positive independent factors for compliance included negative attitudes to screen exposure, co-viewing, engagement, and being a single child.
- Risk model showed good discrimination (AUC 0.845, 0.812) for younger groups, medium (AUC 0.691) for 2-3 year olds.
Conclusions:
- Screen time guideline compliance is generally adequate in Fujian young children.
- A significant deficit in compliance exists for children aged 1-2 years.
- Targeted interventions are essential to enhance compliance, especially for the 1-2 year old age group.
Background:
Compliance with screen time guidelines among children worldwide remains low, and there is insufficient evidence on the current prevalence in China. This study aimed to investigate the prevalence of compliance with screen time guidelines among children under 3 years old in Fujian Province, East China, identify risk factors and their independent effects, and develop a risk discrimination model for targeted interventions.
Methods:
A cross-sectional survey was conducted among low-income families recruited from welfare programs at 96 sites in both urban and rural areas of Fujian Province, China. Face-to-face interviews gathered sociodemographic data, lifestyle information, attitudes towards screen exposure, and details on screen media device ownership. A multivariable logistic regression model was employed to identify independent risk factors for compliance with screen time guidelines, while the area under the receiver operating characteristic curve (AUC) was used to evaluate the model's discrimination ability.
Results:
A total of 4,707 children participated in the survey. The rates of compliance with screen time guidelines were 56.8% for children under 1 year old, 18.8% for those between 1 and 2 years old, and 81.9% for those between 2 and 3 years old. The multivariable regression analysis identified negative attitudes towards screen exposure, co-viewing and engagement, as well as single child, as significant positive independent factors for compliance with the guidelines. The risk discrimination model demonstrated good performance, with an AUC of 0.845 and 0.812 in the two younger age groups, but showed medium discrimination with an AUC of 0.691 for children between 2 and 3 years old.
Conclusions:
Compliance with screen time guidelines among young children in Fujian Province, East China, is generally adequate, but notably low among children between 1 and 2 years old. Targeted interventions are needed to improve compliance, particularly for this age group.
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