Associations between Parental Social Support and Early Childhood Screen-time in US Children

Excessive childhood screen-time is associated with adverse lifestyle and mental health outcomes. Studies suggest that social support, perceived assistance from others, can empower parents to manage screen-time; however, it is unclear which sources of support are relevant and whether income influences these associations. We examined whether individual, family, and neighborhood social support are associated with optimal early childhood screen-time. We performed a cross-sectional analysis of children aged 0-5 years from the 2022 National Survey of Children's Health. Using American Academy of Pediatrics recommendations, we defined optimal screen-time as one hour or less daily. Support was self-reported by parents and included: 1) individual (day-to-day help), 2) family (family cohesion), 3) neighborhood (community support), and 4) cumulative (count 0-3 of all sources). We performed regression analyses, adjusting for race, ethnicity, maternal age, education, and income, with stratification by income. Among 19,741 children (51% male, 65% Non-Hispanic White, 55.9% low-income), 29.9% had optimal screen-time. Individual (OR 1.34, 95% CI, 1.11-1.62), family (OR 1.37, 95% CI, 1.10-1.71), neighborhood (OR 1.16, 95% CI, 1.07-1.38), and cumulative support (OR 2.24, 95% CI, 1.37-3.67) were associated with optimal screen-time. Individual support was associated with optimal screen-time in higher-income families (OR 2.12, 95% CI, 1.61-2.79). Family (OR 1.39, 95% CI, 1.05-1.88), neighborhood (OR 1.45, 95% CI, 1.17-1.66), and cumulative support (OR 2.46, 95% CI, 1.39-4.33) were associated with optimal screen-time in low-income families. All sources of social support are associated with optimal screen-time, but associations vary by income. Strengthening support may promote healthier screen-time, particularly in low-income families.