Tuesday, April 11, 2023

Changes in children’s screen time during pandemic

JAMA Pediatrics

Peer-Reviewed Publication

JAMA NETWORK

About The Study: The largest increase in children’s recreational screen time during the pandemic was on weekdays, especially at the outset of the pandemic when schools were closed; this increase was greater than expected for age-related growth. Change in weekend screen time during the pandemic was not significant compared with weekday screen time. Once in-person school resumed, weekday screen time decreased versus that during the COVID-1 wave (spring 2020), although it remained consistently higher than pre-pandemic estimates and age-related expectations. 

Authors: Sheri Madigan, Ph.D., of the University of Calgary in Calgary, Canada, is the corresponding author.

 link https://media.jamanetwork.com/  (doi:10.1001/jamapediatrics.2023.0393)

Research Letter
April 10, 2023

Changes in Children’s Recreational Screen Time During the COVID-19 Pandemic

JAMA Pediatr. Published online April 10, 2023. doi:10.1001/jamapediatrics.2023.0393

The COVID-19 pandemic changed children’s daily lives, including their sedentary behavior.1 A meta-analysis comparing the screen time duration of 29 017 children reported daily screen time increased from 1.4 hours prepandemic to 2.7 hours during the pandemic.2 However, studies on children’s screen time compared differences from prepandemic to early in the pandemic, when restrictions and closures (eg, schools and gyms) were more prevalent.2 It remains unknown if increases in screen time were sustained as pandemic restrictions changed. We compared children’s prepandemic screen time with screen time during 3 pandemic waves and assessed whether increases were greater than age-expected changes.

Methods

Participants were from All Our Families,3,4 an ongoing pregnancy cohort of mothers and children from Calgary, Alberta, Canada (Table). Data included a 2018 survey of mothers and surveys of mothers and children during 3 pandemic waves: COVID 1 (spring 2020); COVID 2 (winter 2021), and COVID 3 (fall 2021). Screen time (ie, smartphone, tablet, gaming, or computer device use “for fun [outside of schoolwork]”) was reported in hours per typical weekday and weekend day. Schools were closed during the COVID-1 wave but were open during subsequent waves. The University of Calgary Institutional Ethics Board approved this cohort study. Written consent was obtained from participants. We followed the STROBE reporting guideline.

We performed multilevel modeling to compare waves of data collection while controlling for age (as a linear effect) using MPlus, version 8.8 (Muthén & Muthén). Two-sided P < .05 was considered significant. Data were analyzed from July 25 to November 11, 2022.

Results

Participants included 2123 mothers (mean [SD] age at pregnancy, 30.8 [4.4] years) and 1288 children (mean [SD] child age prepandemic, 7.9 [0.6] years; COVID-1 wave, 9.7 [0.8] years; COVID-2 wave, 10.4 [0.9] years; COVID-3 wave, 11.1 [0.8 years). We examined conditional means and 95% CIs across waves according to each participant type (Figure), controlling for age using a daily screen time of 0.12 to 0.15 hours per year of age.

For weekdays, mothers reported 1.35 (95% CI, 1.23-1.47) more mean daily hours of screen at COVID-1 wave vs prepandemic. At the COVID-2 wave, mothers and youths reported fewer hours in daily screen time vs the previous wave (Figure). Mothers reported a larger decrease than youths (−1.06 [95% CI, −1.15 to −0.97] hours vs −0.55 [−0.69 to −0.42] hours). Mean screen time did not differ between the COVID-2 and COVID-3 waves (Figure), although mean screen time was higher for both waves compared with that of prepandemic.

For weekends, participants reported increased mean daily screen time that did not differ significantly at each subsequent wave. However, when averaged, the increase in mean hours per day across waves reported by mothers (0.14 [95% CI, 0.07-0.21] hours) and youth (0.18 [95% CI, 0.10-0.26] hours) was significant. Compared with weekdays, on weekends mean hours of screen time did not significantly differ between prepandemic and COVID-1 wave, and concurrent maternal and youth reports of weekend screen time did not differ significantly.

Discussion

The largest increase in children’s recreational screen time during the pandemic was on weekdays, especially at the outset of the pandemic when schools were closed; this increase was greater than expected for age-related growth. Change in weekend screen time during the pandemic was not significant compared with weekday screen time. Once in-person school resumed, weekday screen time decreased vs that during the COVID-1 wave, although it remained consistently higher than prepandemic estimates and age-related expectations.

Participant agreement varied. Mothers and children reported similar time estimates when schools were closed, but differences in estimates were observed for weekdays when schools were open. If children are the best informants of their screen time, as they often are for their mental health,5 mothers may have underestimated daily weekday screen time or schools may have allowed more screen time when in-person learning resumed.

Study limitations include screen time measurement via self-report only and exclusion of other indicators of screen use: context (ie, connecting with others), content (eg, violent gaming), and type (eg, gaming vs smartphone) of screen use. These limitations warrant future research.

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Article Information

Accepted for Publication: January 22, 2023.

Published Online: April 10, 2023. doi:10.1001/jamapediatrics.2023.0393

Corresponding Author: Sheri Madigan, PhD, Department of Psychology, University of Calgary, 2500 University Ave, Calgary, AL T2N 1N4, Canada (sheri.madigan@ucalgary.ca).

Author Contributions: Drs Plamondon and Madigan had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Tough and Madigan are senior authors.

Concept and design: Plamondon, Eirich, Madigan.

Acquisition, analysis, or interpretation of data: Plamondon, McArthur, Racine, McDonald, Tough, Madigan.

Drafting of the manuscript: Plamondon, Madigan.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Plamondon, McArthur.

Obtained funding: Tough, Madigan.

Administrative, technical, or material support: Eirich, Tough, Madigan.

Supervision: Tough, Madigan.

Conflict of Interest Disclosures: Dr Tough reported receiving grants from Alberta Children’s Hospital Foundation outside the submitted work during the conduct of the study. No other disclosures were reported.

Funding/Support: The All Our Families study was funded by an Alberta Innovates Health Solutions Interdisciplinary Team grant 200700595 and the Alberta Children’s Hospital Foundation (Dr Tough). Funding for the data collection for the COVID-19 pandemic waves was provided by the Canadian Institutes of Health Research and the Children and Screens Institute of Digital Media and Child Development COVID-19 grant (Dr Madigan) and an Alberta Innovates grant (Dr Tough).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See the Supplement.

Additional Contributions: We acknowledge the contributions of the All Our Families research team who were compensated for their contributions to this work, and we thank the participants who took part in the study.

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