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Introduction: There are limited data on the descriptive lifestyle behaviour of school-age children in Singapore. Methods: A total of 100 parents of children ages 5 to 14 participated in a parents’ proxy-reported survey. Frequency of moderate physical activity (PA) and vigorous PA was assessed, while t-tests or chi-square test was used to examine differences between weekdays and weekends for sleep, screen viewing time (SVT) and sedentary behaviour (SB). Results: Of the 100 children (68% of Chinese ethnicity, 59% boys, mean age 9.1±2.9 years), 31% were overweight or obese, with body mass index z-score of >1. For moderate and vigorous PA participation in a typical week, 32.0% and 43.0%, respectively, did not participate, while median (interquartile range) days of participation were 3 (2–3) days/week and 2 (1–3) days/week for a duration of 60 (interquartile range 30–120) minutes/session. When comparing weekends with weekdays, the means (standard deviation) of both SVT and sleep duration were higher on weekends (SVT: 4.1 [2.9] versus 3.3 [3.1] hours/day, P=0.07; sleep: 8.8 [1.5] vs 8.3 [1.3] hours/day, P=0.02), while there were no significant differences for SB. A higher proportion of children had SB of ≥10 hours/day and slept 0.05; sleep:18.8% vs 2.1%, P

The aim of the current study is to investigate the use of screen in young children before and during the pandemic and the attitudes of mothers towards their children's screen-viewing time. To achieve this, 20 mothers who have children between 1.5 and 6 years-old included in the study. The design of this qualitative study is phenomenology to collect more extensive and rich descriptions of experiences. These mothers were selected through convenient sampling method and due to the Covid-19 pandemic; interviews were carried out with one-on-one phone call. 21 open-ended interview questions were used to get information about the participants’ views and practices. The findings showed that there are differences between mothers' expectations and practices about the screen meeting of their children, they could not implement their expectations on their own children, and their children met the screen at an earlier age. Also, findings revealed that mothers are conscious about the influences of screen-viewing and it has both physical and behavioral consequences for their children.

This study aimed at revealing the factors determining grandparental mediation of their grandchildren’s screen viewing and interactive media use, based on online surveys conducted among 291 American and 356 Israeli grandparents who reported taking care of 2-to-7 years old grandchildren at least once a week. Past mediation, familiarity with children’s media, parental instructions and joint leisure activities were positively associated with mediation of both interactive and non-interactive media use, whereas country of residence was not significantly associated with mediation. These findings provide initial knowledge about the universal aspects of grandparental mediation in early childhood.

Educators strongly influence young children’s behaviors, and their perspectives regarding physical activity (PA) and screen-viewing (SV) may influence their provision in childcare. This study gathe...

This review assesses the risk of a photic-induced seizure in a child during viewing of 3D (binocular 3 dimensional, stereoscopic) movies or games, either on standard video displays or when wearing a virtual reality (VR) headset. Studies published by pediatric epilepsy experts emphasize the low risk of 3D viewing even for children with known photosensitive epilepsy (PSE). The low incidence of PSE is noteworthy because the number of hours devoted to 2D or 3D screen viewing and/or VR headset use by children worldwide has increased markedly over the last decade. The medical literature does not support the notion that VR headset use poses a risk for PSE.

In the age of COVID, art teachers face the unprecedented situation of teaching at distance a subject that involves hands-on activities with tangible tools and materials. Therefore, we have implemented e-studio workshops where the mentor and participants are not in the same room, but they interact as if they were. By using audio-video conferencing to link them together, it was possible to maintain two-way communication. This alternative option retains all the elements of live interaction. Since, unlike drawing in a real physical environment, the image on the screen that participants are asked to draw is the same for everyone, there are no views from different angles as in real space. This changes the relationship with the model and requires technical adaptations, which are presented in this article. The goals of the project included bringing distance learning closer to workshop providers, finding the optimal way to develop drawing skills at a distance, finding software that allows quality corrections, adapting the way knowledge is delivered to people with different needs, and enabling social interaction between participants and the mentor. Such an approach opened up new perspectives on the experience of drawing from a model and on the nature of drawing instruction.

Importance: screen-viewing in adults has been associated with greater abdominal adiposity, with the magnitude of associations varying by sex and ethnicity, but the evidence is lacking at younger ages. We aimed to investigate sex- and ethnic-specific associations of screen-viewing time at ages 2 and 3 years with abdominal adiposity measured by magnetic resonance imaging at age 4.5 years.Methods: The Growing Up in Singapore Towards healthy Outcomes is an ongoing prospective mother-offspring cohort study. Parents/caregivers reported the time their child spent viewing television, handheld devices and computer screens at ages 2 and 3 years. Superficial and deep subcutaneous and visceral abdominal adipose tissue volumes were quantified from magnetic resonance images acquired at age 4.5 years. Associations between screen-viewing time and abdominal adipose tissue volumes were examined by multivariable linear regression adjusting for confounding factors.Results: in the overall sample (n=307), greater total screen-viewing time and handheld device times were associated with higher superficial and deep subcutaneous adipose tissue volumes, but not with visceral adipose tissue volumes. Interactions with child sex were found, with significant associations with superficial and deep subcutaneous and visceral adipose tissue volumes in boys, but not in girls. Among boys, the increases in mean (95% CI) superficial and deep subcutaneous and visceral adipose tissue volumes were 24.3 (9.9, 38.7), 17.6 (7.4, 27.8), and 7.8 (2.1, 13.6) mL per hour increase in daily total screen-viewing time, respectively. Ethnicity-specific analyses showed associations of total screen-viewing time with abdominal adiposity only in Malay children. Television viewing time was not associated with abdominal adiposity.Conclusion: greater total screen-viewing time (and in particular, handheld device viewing time) was associated with higher abdominal adiposity in boys and Malay children. Additional studies are necessary to confirm these associations and to examine screen-viewing interventions for preventing excessive abdominal adiposity and its adverse cardiometabolic consequences.

Background: Effects of using mobile devices on childhood obesity have not been well studied. We aimed to ascertain whether cell phone use and screen viewing are associated with excess body...

Background Physical activity (PA) offers numerous health benefits for young children; however, many children enrolled in childcare engage in low levels of PA and high levels of sedentary time. This study aimed to describe the prevalence and content of written PA and screen-viewing (SV) policies in Canadian childcare centers. Methods Using a modified version of the Environment and Policy Assessment and Observation Self-Report (EPAO-SR) tool, an online survey was distributed to all directors/administrators of center-based childcare facilities across Canada. Reminder emails were sent to encourage survey completion and a strong response rate. Descriptive statistics were used to explore demographic characteristics and frequencies were run to examine the number of centers that implemented a PA or SV policy. Deductive content analysis was completed to identify common themes in participants’ open-ended responses. Results A total of 1158 childcare representatives participated in the study; 514 provided complete data. Of these, 295 (44%) centers indicated having a written PA policy (with the majority regulated at the provincial/territorial-level; n = 227; 42%). Content of these policies included amount of time: spent outdoors (n = 395; 63%); in teacher-led active play (n = 101; 16%); and PA education for children (n = 91; 16%). Additionally, 178 (29%) respondents reported a written policy regarding SV (with majority regulated at the center-level; n = 173; 34%) and primarily focusing on amount of time children watch television. Conclusions PA regulations are more common than SV policies in Canadian childcare centers; however, less than half implement a PA policy and only a third adopt SV regulations. An opportunity exists to advance practice by adopting proactive approaches to encouraging young children to be more active and less sedentary in childcare (i.e., through written policies). Supplementing policy with accessible resources, as well as consistent provision of early childhood educator (staff) training, represent important steps for putting said policies into action.

Background Early childhood educators greatly influence young children’s physical activity and screen-viewing behaviours in childcare. However, educators have requested additional training in physical activity programming, and one logical place to provide this education is during their pre-service schooling. This study explored the physical activity and screen-viewing-related knowledge, training, and self-efficacy of early childhood education (ECE) candidates across Canada, to determine their confidence and ability to facilitate physical activity opportunities and limit screen-viewing among young children in childcare. Methods Key program personnel at 61 (of 110) Canadian colleges/universities offering an ECE program agreed to participate in this cross-sectional study. An online survey (112 items; 9 domains), developed by experts using the Tailored Design Method, was administered via Qualtrics© to a sample of 1292 ECE candidates. Descriptive statistics, Mann-Whitney U-tests, and chi-square tests were used to report participant demographics and physical activity and screen-viewing-related knowledge (i.e., of physical activity and screen-viewing concepts), training (i.e., physical activity and screen-viewing courses/content received), and self-efficacy (i.e., to facilitate physical activity and limit screen-viewing in childcare) of candidates. Results ECE candidates exhibited the least amount of knowledge regarding the impact of screen-viewing on physiological outcomes (i.e., blood pressure) in young children. Further, only 32.2 and 26.7% of candidates reported completing physical activity or screen-viewing courses during their post-secondary training, respectively. Candidates who completed one or more physical activity or screen-viewing courses exhibited significantly greater (p

BACKGROUND Excessive screen viewing and background TV exposure are common problems all over the world. Therefore, intervention studies have gained importance. This study aims to investigate the effectiveness of family-based, developmental pediatrics clinic setting counseling in reducing screen time in typically developing children and to compare them with neurodevelopmental disorders. METHODS Children (aged 24-62 months) who were exposed to screen viewing for at least 2 hours/day were included. Parents were given three counseling sessions to reduce excessive screen time. Parents reported daily screen time, co-viewing, background TV exposure, the duration of reading books and playing with their child. RESULTS The study included 105 children (median age: 34 months IQR:28-41). Before counseling, the screen viewing time and the percentage of co-viewing among typically developing children (n=22) and children with a neurodevelopmental disorder (n=83) were similar. There was a statistically significant decrease in screen time in both groups after the intervention. A higher impact was shown in the neurodevelopmental disorder group. The increase in percentages of co-viewing, as well as the increase in the time spent playing with their children, were statistically significant in the neurodevelopmental disorder group. CONCLUSIONS The study demonstrated that three pediatric office-setting counseling sessions including media use recommendations of the American Academy of Pediatrics are effective to decrease screen time for children who are either typically developing or with a neurodevelopmental disorder.

Amaç Sağlık sistemi bütün çocuklara sosyoekonomik durumdan bağımsız olarak erişebilmenin tek yoludur ve çocuk sağlığı hizmeti verenler ailelere ulaşabilmek için anahtar konumdadırlar. Günümüzde oyun, okuma ve ekran izleme alışkanlıkları çocukların gelişimini etkileyen en temel konular olarak bilinmektedir ancak bu alışkanlıklara dair ülkemizde yeterli veri yoktur. Çalışmamızda ebeveynlerin çocuklarıyla oyun oynama, kitap okuma ve ekran izletme alışkanlıklarını değerlendirmeyi ve bu alışkanlıkların sağlık sisteminin her düzeyinde nasıl ayrıştığını araştırmayı amaçladık.Gereç ve yöntemlerGelişimsel Pediatri Bilim Dalı tarafından Ocak2015- Ocak 2016 tarihleri arasında yürütülen bu çalışmada1-6 yaş arasındaki çocuklarına yönelik tıbbi bir hizmet için başvuran toplam451 ebeveyne (156’ sı üçüncü basamak sağlık merkezi-Üniversite Hastanesi-ÜH,148 'i ikinci basamak sağlık merkezi-Devlet Hastanesi-DH ve 147 'si birincibasamak sağlık merkezi- Aile Sağlığı Merkezi-ASM) bir anket verildi. Bu ankettesosyodemografik bilgilerin yanında ebeveynlerin çocukları ile oyun oynama,çocuklarına kitap okuma ve çocukların televizyon izleme alışkanlıklarıdeğerlendirildi.BulgularToplam örneklemde her 5 ebeveynden 1' i çocuklarıyla oyun oynamıyordu, kurumlar arası fark yoktu (p=0,063) ancak oynamayanlar DH' de (% 25,3) en fazlaydı. Oyun oynamama düşük sosyoekonomik durumla ilişkiliydi (p=0,020). Ebeveynlerin % 46,3’ ü çocuklarına kitap okumuyordu, kurumlar arası fark vardır (p=0,021), okumayanlar ÜH' de (% 51,9) en fazlaydı. Yaşla kitap okuma oranları artmaktaydı (p = 0,000), ortanca başlangıç yaşı 23 aydı. Kitap okumamayı etkileyen faktörler çocuk yaşı, anne yaşı ve sosyoekonomik durumdu (p

The purpose of this study is to identify regional differences in outdoor activity time and screen-viewing time of preschool children in urban and rural areas and to provide data on the environmental factors to identify modifiable determinants for each region. This cross-sectional study was conducted on 1772 out of 2790 children between the age of 3 to 6 years living in northern China, with their consent. A cross-sectional study was conducted among preschool children living in urban (n = 1114) and rural areas (n = 658) in northern China. To assess environmental factors, the International Physical Activity Questionnaire was used for neighborhood environments, and the questionnaire included three items each for the physical home environment and socio-cultural environment domains. We observed the associations between outdoor play for urban children and sidewalks in the neighborhood, paths for cycles, aesthetic qualities, and &ldquo, motor vehicles. In addition, in rural areas, screen-viewing time and environmental factors were found to be positively correlated with traffic, limited place and method of outdoor play, and were negatively correlated with the importance of academics and need for company in outdoor play. This has important implications for the development of effective intervention programs for preschool children in China in the future.

Background: Screen viewing is a sedentary behaviour reported to interfere with sleep and physical activity. However, few longitudinal studies have assessed such associations in children of preschool age (0–6 years) and none have accounted for the compositional nature of these behaviours. We aimed to investigate the associations between total and device-specific screen viewing time at age 2–3 years and accelerometer-measured 24 h movement behaviours, including sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity (MVPA) at age 5·5 years. Methods: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study is an ongoing longitudinal birth cohort study in Singapore, which began in June 2009. We recruited pregnant women during their first ultrasound scan visit at two major public maternity units in Singapore. At clinic visits done at age 2–3 years, we collected parent-reported information about children's daily total and device-specific screen viewing time (television, handheld devices, and computers). At 5·5 years, children's movement behaviours for 7 consecutive days were measured using wrist-worn accelerometers. We assessed the associations between screen viewing time and movement behaviours (sedentary behaviour, light physical activity, MVPA, and sleep) using Dirichlet regression, which accounts for the compositional nature of such behaviours. This study is active but not recruiting and is registered with ClinicalTrials.gov, NCT01174875. Findings: Between June 1, 2009, and Oct 12, 2010, 1247 pregnant women enrolled and 1171 singleton births were enrolled. 987 children had parent-reported screen data at either 2 or 3 years, of whom 840 attended the clinic visit at age 5·5 years, and 577 wore an accelerometer. 552 children had at least 3 days of accelerometer data and were included in the analysis. Total screen viewing time at age 2–3 years had a significant negative association with sleep (p=0·008), light physical activity (p

Children&rsquo, s screen-viewing behavior is influenced by parents&rsquo, own screen-viewing hours and the parental rules set for screen-viewing time. However, whether childhood obesity is associated with these three factors has not been widely investigated in Chinese populations. We examined the relationships between parental rules, parental screen-viewing, child screen-viewing and child overweight. Questionnaires were distributed to 1300 parents who had children studying in two elementary schools in an eastern Taiwanese City (Yi-Lan). We collected the data (the final response rate was 77.7%) on children&rsquo, s health states, the length of screen-viewing time, and whether parental rules of screen-viewing time have been set (n = 1005). Models using structural equation modeling, with controlling of age, gender, and physical activity of the participants, were carried out, to examine the mediated effect of child screen-viewing. The results of model testing showed that child screen-viewing could be a mediator in the associations between parental rule and child overweight (parental rule: coefficient = &minus, 0.18, p &lt, 0.001), and between parent screen-viewing and child overweight (parent screen-viewing: coefficient = 0.072, p &lt, 0.001). These findings suggested that parental factors (rules and little screen viewing time) effectively decreased the level of children&rsquo, s screen-viewing time, and the child screen-viewing time could mediate the association between parental factors and child overweight in the Chinese population.

Physical activity (PA) is essential for children’s health and well-being, yet many children around the world do not meet the recommended PA levels. Screen-viewing behavior is one of the possible factors leading to low levels of PA and being overweight. Although research in Western countries shows that caregivers’ screen-viewing behavior and rule-setting are associated with their children’s screen-viewing behavior, these results may not be generalizable to East Asian populations. Therefore, the current study proposed two mediation models to investigate whether insufficient physical activity mediates the relationship between children’s screen viewing behavior and overweight status, and whether such screen-viewing behavior mediates the relationship between caregiver factors and children’s overweight status. The participants in this study comprised 1031 elementary school students (516 boys and 515 girls) in Taiwan. Through a cross-sectional design, caregivers reported their children’s PA levels, screen-viewing time, body mass index (BMI), home environment, and caregivers’ rules regarding screen-time restrictions. Additionally, an χ2 test was used to examine the differences between children with and without sufficient PA. The results from χ2 tests suggest that, in the insufficient PA group, the caregivers tended to have excessive screen time per day and have no rules to manage their children’s screen-viewing behavior. Furthermore, the children in this group were more likely to have excessive screen-viewing time per day than their counterparts. Sobel tests revealed that insufficient PA was a mediator in the relationship between children’s screen-viewing behavior and being overweight. Children’s screen-viewing behavior was also found to be a mediator in the relationship between caregivers’ factors and being overweight. The results of the current study indicate that caregivers’ screen-viewing behavior and caregivers’ screen-viewing rules may be associated with their children’s insufficient PA levels and overweight problems, which, in turn, are related to their children’s screen-viewing behavior. Future efforts at childhood overweight intervention should consider the inclusion of educational and behavioral programs designed for caregivers, rather than targeting children alone.

Aims What helps children learn: is it a presence of a live teacher or an interaction with the learning materials? Addressing this question, we manipulated a teacher’s presence (on-screen vs. present) and activity (observing vs. doing) while teaching children about the properties of geometric shapes. Method Five-year-olds (n = 215) completed two shape-sorting tasks in which they distinguished between typical, atypical and non-valid shapes. In between these tasks, they took part in one of four training sessions: doing teacher-present, observing teacher-present, doing teacher-on-screen and observing teacher-on-screen. Results Although children’s shape knowledge improved across all training conditions, learning showed an interaction between teacher presence and task difficulty. In a teacher’s presence, children learned more about the most difficult (atypical) shapes, irrespective of activity. It may be the social interaction, associated with a teacher’s presence, that enhances learning. Conversely, physically taking part in interactive touchscreen training did not result in more learning than passive screen viewing.

Mega events, such as the Olympics, provide a unique context and valuable opportunity to study changing media use patterns in today’s convergent environment. This study examined how and why audiences watched the 2016 Rio Olympics across media, and found that while TV was still the dominant platform for mega-event viewing, audiences tended to seek alternative content and niche sports on computers, and primarily used mobile devices to get a second-screen experience during the Rio Games. In addition, findings suggest that multiscreen Olympics viewing was not exclusively determined by individual characteristics and psychological needs. Structures, media use routine, and social contexts played a big (though maybe less obvious) role in driving screen choice.

This study responds to recent calls for data regarding a phenomenon referred to as two-screen viewing (TSV), in which people on social network sites (SNSs) interact with each other regarding TV series they watch. Specifically, the current study aims to provide empirical evidence pertaining to (a) motivations for TSV, (b) TV-related social interactions on SNSs, (c) the relationships between motivations and social interactions, and (d) the effects of psychological traits on the motivations. Based on an online survey of 442 TV series viewers who used SNSs to interact with other viewers, three primary TSV motivations were identified: social co-viewing, engagement, and passing time. Social interactions were categorized into social sharing and issue surveillance. Motivations were differently associated with actual social interaction types: Engagement and passing time were associated with social sharing, whereas social co-viewing was related only to issue surveillance. In addition, certain psychological traits (e.g., innovativeness, behavioral activation systems) had significant impacts on TSV users' motivations. Taken together, these results illuminate the nature of TSV motivations and behaviors as well as their psychological antecedents.

Sedentary time and screen-viewing (SV) are associated with chronic disease risk in adults. Parent and child sedentary time and SV are associated. Parents influence children's SV through parenting styles and role modelling. Understanding whether parents' attitudes toward child SV are associated with their own SV and sedentary time will aid development of family interventions to reduce sedentary behaviours. Cross-sectional data with 809 parents from Bristol, UK were collected in 2012–2013 and analysed in 2016. Parental total sedentary time was derived from accelerometer data. Parents self-reported daily television viewing, use of computers, games consoles, and smartphone/tablets (none, 1–59 min, 1–2 h, > 2 h) and attitudes toward child SV. Adjusted linear and logistic regression models were used to examine associations, separately for weekdays and weekend days. Having negative attitudes toward child SV was associated with lower weekend sedentary time (Coeff: − 6.41 [95% CI: − 12.37 to − 0.45] min/day). Limiting behaviours and having negative attitudes toward child SV were associated with lower weekday television viewing (OR: 0.72 [0.57–0.90] and 0.57 [0.47–0.70] respectively), weekend television viewing (0.75 [0.59–0.95] and 0.61 [0.50–0.75]), and weekend computer use (0.73 [0.58–0.92] and 0.80 [0.66–0.97]). Negative attitudes were also associated with lower smartphone use on weekdays (0.70 [0.57–0.85]) and weekends (0.70 [0.58–0.86]). Parent self-efficacy for limiting child SV and setting SV rules were not associated with sedentary time or SV. Reporting negative attitudes toward child SV was associated with lower accelerometer-assessed weekend total sedentary time and self-reported SV behaviours, while limiting child SV was also associated with lower self-reported SV., Highlights • Limiting child SV is associated with lower TV viewing and computer use in parents. • Having negative attitudes toward child SV is associated with lower SV in parents. • Negative attitudes toward child SV are associated with lower parent sedentary time. • Self-efficacy for limiting SV is not associated with parents' SV & sedentary time. • Setting SV rules for children is not associated with parents' SV & sedentary time.

The Olympic Games are a global sports mega-event where the aggregation of mass audiences is still observable at a time when multiplying forms of personalized connective media – digital, mobile and ...

Aim This study examined the relationships between energy balance-related behaviours outside school hours and obesity in Chinese primary school students. We also explored the influence of gender on those relationships. Methods The study sample was a cross-sectional cohort of 5,032 Chinese children who were enrolled in grades 1-6 in primary schools in five Chinese cities and whose mean ages ranged from 7.3 to 11.9 years. The children's parents completed a survey on their child's height, weight and energy balance-related behaviours outside school hours. Results The response rate was 97% and the reported rates of overweight and obesity were 13.6% and 13.8%, respectively. The obesity rates were higher in boys and lower grade children. Most energy balance-related behaviours varied between boys and girls and with increased grade levels. The amount of time spent on academic-related activities, screen viewing, outdoor activities and sleep were mostly associated with obesity on weekdays and varied by gender. Conclusion Rate of obesity were alarmingly high in the primary school Chinese children in this cohort, especially in younger children. Excessive time spent on academic-related activities outside school hours, inadequate sleep, physical inactivity and higher levels of screen viewing were major contributors to obesity in these Chinese children. This article is protected by copyright. All rights reserved.

We propose Tiger, an eyewear system for helping users follow the 20-20-20 rule to alleviate the Computer Vision Syndrome symptoms. It monitors user's screen viewing activities and provides real-time feedback to help users follow the rule. For accurate screen viewing detection, we devise a light-weight multi-sensory fusion approach with three sensing modalities, color, IMU, and lidar. We also design the real-time feedback to effectively lead users to follow the rule. Our evaluation shows that Tiger accurately detects screen viewing events, and is robust to the differences in screen types, contents, and ambient light. Our user study shows positive perception of Tiger regarding its usefulness, acceptance, and real-time feedback.

Physical activity levels decline, and screen-viewing behaviours increase during childhood and adolescence. The transition to secondary school appears to coincide with a sharp decline in physical activity. Parents have the potential to influence their child&rsquo, s behaviours, yet little is known about their expectations for their child&rsquo, s physical activity and screen-viewing during this transition. This paper explores parents&rsquo, expectations for their children&rsquo, s physical activity and screen-viewing as they transition from primary to secondary school, and their proposed strategies for managing these behaviours during this time. Forty-two parents of children aged 10&ndash, 11 years participated in a semi-structured telephone interviews in July 2017 or March 2018. The interview data were analysed via inductive and deductive content analysis to explore parents&rsquo, perceptions of physical activity and screen-viewing during the transition, the reasons for their perceptions, and the strategies they intended to implement to help their child balance their behaviours. Most parents expected both physical activity and screen-viewing to increase during this transition. There were several individuals, social and school-level factors influencing these expectations. Overall, parents felt that helping their child balance their activity levels, screen-viewing and homework would be challenging.

Objective: Screen-viewing in late childhood has been associated with adiposity and blood pressure (BP), but evidence is lacking at younger ages. To investigate the prospective associations of total and device-specific screen-viewing at age 2–3 years with BMI, sum of skinfold thicknesses and BP among Singaporean children at age 3–5 years. Methods: As part of the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort, mothers/caregivers reported the time per day their 2 and 3-year-old children watched/used television, handheld devices and computers. Average screen-viewing time (total, television and handheld-devices) at ages 2 and 3 years was used in the analyses. Height; weight; triceps, biceps and subscapular skinfold thicknesses; and systolic and diastolic BP were measured at ages 3, 4 and 5. Associations of screen-viewing with BMI, sum of skinfold thicknesses and BP in 956 children were investigated using repeated-measures linear regression models. Analyses were further stratified by sex as we found significant interaction. Results: Among boys and girls combined, screen-viewing was positively associated with sum of skinfold thicknesses, but not with BMI or BP. Sex-specific analyses showed significant associations with both BMI and sum of skinfold thicknesses in boys, but not in girls. Screen-viewing was not associated with BP in boys or girls. The increases in mean (95% CI) BMI per hour increase in daily total, television and handheld-devices screen-viewing among boys were 0.12 (0.03, 0.21), 0.18 (0.06, 0.30) and 0.11 (−0.07, 0.29) kg/m2, respectively. The corresponding increases in mean sum of skinfold thicknesses were 0.68 (0.29, 1.07), 0.79 (0.26, 1.32) and 1.18 (0.38, 1.99) mm. Conclusions: Greater screen-viewing at age 2–3 years was associated with later adiposity at 3–5 years in boys, but not in girls. In light of the increasing use of screen devices and cardiometabolic risk in young children, these findings may have important public health implications. Agency for Science, Technology and Research (A*STAR) Ministry of Health (MOH) National Medical Research Council (NMRC) National Research Foundation (NRF) This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore- NMRC/TCR/004-NUS/2008; NMRC/TCR/012- NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union’s Erasmus + Capacity-Building ENeASEA Project and Seventh Framework Programme (FP7/2007- 2013), projects EarlyNutrition and ODIN under grant agreement numbers 289346 and 613977. We would like to thank GUSTO study group, operational managers, research fellows, study coordinators and data management team. We greatly appreciate voluntary participation of all participants, and cooperation of KK Women’s and Children’s Hospital and National University Hospital. The GUSTO study group includes Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah Lee, Birit F.P. Broekman, Boon Long Quah, Borys Shuter, Chai Kiat Chng, Cheryl Ngo, Choon Looi Bong, Christiani Jeyakumar Henry, Claudia Chi, Cornelia Yin Ing Chee, Yam Thiam Daniel Goh, Doris Fok, E Shyong Tai, Elaine Tham, Elaine Quah Phaik Ling, Evelyn Xiu Ling Loo, George Seow Heong Yeo, Helen Chen, Heng Hao Tan, Hugo P S van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee-Man Lau, Izzuddin Bin Mohd Aris, Jeevesh Kapur, Jenny L. Richmond, Jerry Kok Yen Chan, Joanna D. Holbrook, Joanne Yoong, Joao N. Ferreira, Jonathan Tze Liang Choo, Joshua J. Gooley, Krishnamoorthy Niduvaje, Kuan Jin Lee, Leher Singh, Lieng Hsi Ling, Lin Lin Su, Ling-Wei Chen, Lourdes Mary Daniel, Marielle V. Fortier, Mark Hanson, Mary Foong-Fong Chong, Mary Rauff, Mei Chien Chua, Melvin Khee-Shing Leow, Michael Meaney, Mya Thway Tint, Neerja Karnani, Ngee Lek, Oon Hoe Teoh, P. C. Wong, Paulin Tay Straughan, Pratibha Agarwal, Queenie Ling Jun Li, Rob M. van Dam, Salome A. Rebello, S. Sendhil Velan, Seng Bin Ang, Shang Chee Chong, Sharon Ng, Shiao-Yng Chan, Shu-E Soh, Sok Bee Lim, Stella Tsotsi, Chin-Ying Stephen Hsu, Sue Anne Toh, Swee Chye Quek, Victor Samuel Rajadurai, Walter Stunkel, Wayne Cutfield, Wee Meng Han, Wei Wei Pang, Yin Bun Cheung, Yiong Huak Chan.

Purpose To examine the influence of parents' screen viewing (SV) duration and self-efficacy in limiting SV on their adolescents' loneliness, and to explore the influence of adolescents' SV duration and self-efficacy in limiting SV on parents' loneliness. Design and methods A cross-sectional survey with 1573 adolescent-parent dyads from the Family Life, Activity, Sun, Health, and Eating Study were included in this study. The actor-partner interdependence models were used to examine the effect of each dyadic partner's SV duration and self-efficacy in limiting SV on their own and their dyadic partner's loneliness within adolescent-parent dyads. Results There were no significant actor and partner effects of SV duration on loneliness for both parents and adolescents (all ps > 0.05). Adolescents' self-efficacy in limiting SV was associated with less loneliness of their own (adolescents' actor effect: β = −0.35, SE = 0.04, p Conclusions Adolescents' own self-efficacy in limiting SV has a significant impact on their parents' loneliness. Parents' self-efficacy in limiting SV, however, did not influence their adolescents' loneliness. Practice implications Our results highlight the importance of providers screening for loneliness as part of the plan of care for adolescents and parents who might have excessive SV, with close attention given to those who possess less self-efficacy in controlling their SV.

Physical activity and screen viewing are associated with cardio-metabolic risk factors, psychological wellbeing, and academic performance among children. Across the last generation, children’s physical activity and screen viewing behaviours have changed, coinciding with changes to the home and neighbourhood environment. This study aimed to qualitatively explore parents’ views on their 8⁻9-year-old child’s childhood and how this compares to experiences from their own childhood, with a specific focus on physical activity and screen viewing behaviours. Semi-structured telephone interviews were conducted with 51 parents (mean age = 41.2 years, range 31.5 to 51.5 years), between July and October 2016. Inductive and deductive content analyses were used to explore parents’ perceptions of their child’s physical activity and screen viewing behaviours in comparison to their own childhood behaviours. Interview data revealed that compared to the relative freedom they recalled as children, parents restrict their children’s independent mobility and outdoor play due to concerns about safety. Despite their children having greater access to structured activities than they did as children, parents feel their children are “missing out,„ and perceived their own childhood as better with regards to maximising independent and outdoor play and limiting screen viewing. Innovative strategies are needed to change the social norms surrounding children’s independent mobility and outdoor play.