Prevalence and correlates of screen time in youth: An international perspective

Background: Screen time (including TV viewing/computer use) may be adversely associated with metabolic and mental health in children. 

Purpose: To describe the prevalence and sociodemographic correlates of screen time in an international sample of children aged 4–17 years. 

Methods: Data from the International Children’s Accelerometry Database were collected between 1997–2009 and analyzed in 2013. Participants were 11,434 children (48.9% boys; mean [SD] age at first assessment, 11.7 [3.2] years). Exposures were sex, age, weight status, maternal education, and ethnicity. The outcome was self- or proxy-reported screen time <2 or >2 hours/day. Analyses were conducted initially at study level and then combined using random-effects meta-analysis. 

Results: Within each contributing study, at least two thirds of participants exceeded 2 hours/day of screen time. In meta-analytic models, overweight or obese children were more likely to exceed 2 hours/day of screen time than those who were non-overweight (OR=1.58, 95% CI=1.33,1.88). Girls (vs boys: 0.65; 0.54, 0.78) and participants with more highly educated mothers (vs <university level: 0.53; 0.42, 0.68) were less likely to exceed 2 hours/day of screen time. Associations of age and ethnicity with screen time were inconsistent at study level and non-significant in pooled analyses. 

Conclusions: Screen time in excess of public health guidelines was highly prevalent, particularly among boys, those who were overweight or obese, and those with mothers of lower educational attainment. The population-attributable risk associated with this exposure is potentially high; further efforts to understand the determinants of within- and between-country variation in these behaviors and inform the development of effective behavior change intervention programs is warranted.