School of Public Health, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
PLoS One. 2020 Sep 4;15(9):e0237725. doi: 10.1371/journal.pone.0237725. eCollection 2020.
Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5-11 years), early adolescents (12-14 years), and older adolescents (15-18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era.
近几十年来，技术的发展增加了年轻人对基于屏幕的技术（屏幕时间）的接触，同时也观察到年轻人与自然的接触（绿色时间）减少了。这种高屏幕时间和低绿色时间的结合可能会影响心理健康和幸福感。本系统范围综述的目的是整理评估屏幕时间、绿色时间与心理结果（包括心理健康、认知功能和学业成绩）之间关系的证据，这些结果适用于幼儿（<5 岁）、学童（5-11 岁）、青少年早期（12-14 岁）和青少年晚期（15-18 岁）。在四个数据库（PubMed、PsycInfo、Scopus、Embase）中确定了原始的定量研究，共纳入 186 项符合条件的研究。其中三分之一的研究是在欧洲进行的，几乎同样多的研究是在美国进行的。大多数研究是横断面研究（62%）。一般来说，高水平的屏幕时间似乎与不良的心理结果有关，而绿色时间似乎与良好的心理结果有关。屏幕时间和绿色时间的概念化和测量方式高度多样化，限制了对文献的综合能力。尽管暴露测量存在差异，但大量具有相似发现的横断面研究表明，结果不是人为的。然而，需要更多高质量的纵向研究和随机对照试验来证明因果关系。不同的发展阶段似乎塑造了哪些暴露因素和结果是重要的。来自低社会经济背景的年轻人可能会受到高屏幕时间和低绿色时间的不成比例的影响。未来的研究应该区分被动和互动的屏幕活动，以及对自然的偶然和有意接触。很少有研究同时考虑屏幕时间和绿色时间，以及可能的相互心理影响。然而，有初步证据表明绿色时间可以缓冲高屏幕时间的后果，因此在高科技时代，自然可能是促进年轻人心理健康的未充分利用的公共卫生资源。
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