Department of Population and Family Health, Mailman School of Public Health, 60 Haven Avenue, B-2 Room 211, New York, NY 10032, USA.
Int J Behav Nutr Phys Act. 2013 Aug 23;10:102. doi: 10.1186/1479-5868-10-102.
A large percentage (68%) of children under age 3 use screen media, such as television, DVDs and video games, on a daily basis. Research suggests that increased screen time in young children is linked to negative health outcomes, including increased BMI, decreased cognitive and language development and reduced academic success. Reviews on correlates of screen time for young children have included preschool age children and children up to age 7; however, none have focused specifically on correlates among infants and toddlers. As research suggests that screen media use increases with age, examining correlates of early media exposure is essential to reducing exposure later in life. Thus, this paper systemically reviews literature published between January 1999 and January 2013 on correlates of screen time among children between 0 and 36 months of age.
Two methods were used to conduct this review: (1) Computerized searches of databases (PubMed, PsycINFO, ERIC, Medline); and (2) Reference sections of existing reviews and primary studies. Inclusion criteria were: (1) The article included separate data for children 36 months and younger, (2) English language, (3) peer reviewed article, (4) analysis reported for screen viewing as a dependent variable, (5) original research article and, (6) examined correlates or associations between screen time and other demographic, contextual or behavioral variables. Articles were compiled between 2011 and 2013 and evaluation occurred in 2012 and 2013.
The literature search identified 29 studies that met inclusion criteria. These studies investigated a total of 33 potential correlates, which were examined in this review. Findings suggest demographic variables most commonly correlated with high screen time among infants and toddlers are child's age (older) and race/ethnicity (minority). Child BMI, maternal distress/depression, television viewing time of the mother and cognitive stimulation in the home environment were also associated with screen media use. Studies reported that child sex, first born status, paternal education, non-English speaking family, two-parent household, number of children in the home and non-parental childcare were not associated with screen time among children aged 0-36 months. Associations were unclear (fewer than 60% of studies report an association) for maternal age, maternal education and household income. The remaining correlates were investigated in fewer than three studies and thus not coded for an association.
The correlates identified in this study point to avenues for intervention to reduce screen time use in young children. However, further research is necessary to explore a number of environmental, socio-cultural and behavioral correlates that are under-examined in this population and may further inform prevention and intervention strategies.
很大比例（68%）的 3 岁以下儿童每天都会使用屏幕媒体，如电视、DVD 和视频游戏。研究表明，幼儿的屏幕时间增加与负面健康结果有关，包括 BMI 增加、认知和语言发育迟缓以及学业成绩下降。关于幼儿屏幕时间的相关性的综述包括学龄前儿童和 7 岁以下儿童；然而，没有一项专门针对婴儿和幼儿的相关性进行研究。由于研究表明屏幕媒体的使用随着年龄的增长而增加，因此研究早期媒体暴露的相关性对于减少以后的暴露至关重要。因此，本文系统地综述了 1999 年 1 月至 2013 年 1 月期间发表的关于 0 至 36 个月儿童屏幕时间相关性的文献。
采用两种方法进行综述：（1）计算机检索数据库（PubMed、PsycINFO、ERIC、Medline）；（2）现有综述和原始研究的参考文献部分。纳入标准为：（1）文章包括 36 个月以下儿童的单独数据；（2）英语语言；（3）同行评审文章；（4）分析报告屏幕观看作为因变量；（5）原始研究文章；（6）检查屏幕时间与其他人口统计学、背景或行为变量之间的相关性或关联。文章于 2011 年至 2013 年汇编，评估于 2012 年和 2013 年进行。
文献检索确定了 29 项符合纳入标准的研究。这些研究共调查了 33 个潜在的相关性，本研究对这些相关性进行了考察。研究结果表明，与婴儿和幼儿高屏幕时间最常相关的人口统计学变量是儿童年龄（较大）和种族/民族（少数民族）。儿童 BMI、母亲的困扰/抑郁、母亲看电视的时间以及家庭环境中的认知刺激也与屏幕媒体的使用有关。研究报告称，儿童性别、第一胎出生、父亲的教育程度、非英语家庭、双亲家庭、家中儿童数量和非父母照顾与 0-36 个月儿童的屏幕时间无关。母亲年龄、母亲教育程度和家庭收入的关联不太明确（少于 60%的研究报告存在关联）。其余相关性在不到三项研究中进行了调查，因此未对其关联性进行编码。
本研究确定的相关性为减少幼儿屏幕时间使用提供了干预途径。然而，需要进一步研究来探索该人群中研究不足的许多环境、社会文化和行为相关性，这可能进一步为预防和干预策略提供信息。
