Tooth Leigh R, Moss Katrina M, Mishra Gita D
The University of Queensland, Centre for Longitudinal and Life Course Research, School of Public Health, Herston, Queensland 4006, Australia.
The University of Queensland, Centre for Longitudinal and Life Course Research, School of Public Health, Herston, Queensland 4006, Australia.
Prev Med. 2021 Dec;153:106795. doi: 10.1016/j.ypmed.2021.106795. Epub 2021 Sep 8.
This study investigated family contextual effects on the association between screen time, behaviour and health-related quality of life (HRQOL) in child siblings. Data were from 1772 participants in the Australian Longitudinal Study of Women's Health 1973-78 cohort and their three youngest children (N = 4010 siblings) aged two to 12, collected in Mothers and their Children's Health cross-sectional sub-study (2016/17). The exposure was average daily recreational screen time (televisions, computers, tablets, mobile phones, electronic games). Outcomes were child overall behaviour and prosocial behaviour, and psychosocial and physical HRQOL. Multilevel models were used to test 1) the absolute effect of screen time, and 2) change in the child's outcomes when their own screen time changes relative to their siblings (within-family contextual effects) and change in the child's outcomes when the sibling average screen time changes (between-family contextual effects). The children were average 7.37 years (SD 2.76). There was an absolute effect of screen time on behaviour and HRQOL. Between-family effects were found for child total behaviour (0·22 (95%CI, 0.06, 0.37)) and prosocial behaviour (-0.10 (-0.17, -0.04)), but there were no within-family effects. For HRQOL, within-family effects were found for psychosocial (-0.97 (-1.91, -0.02)) and physical (-1.32 (-2.25, -0.39)) HRQOL, but no between-family effects were found. In conclusion, the higher the average screen time by all children in the family, the worse the child's behaviour, while the greater the deviation of the child's screen time from their siblings, the poorer their HRQOL. Family contextual factors should be considered in screen time research and screen time recommendations.
本研究调查了家庭环境因素对同胞儿童屏幕使用时间、行为及健康相关生活质量（HRQOL）之间关联的影响。数据来自澳大利亚妇女健康纵向研究1973 - 78队列中的1772名参与者及其年龄在2至12岁的三个最小的孩子（N = 4010名同胞），这些数据收集于“母亲与子女健康”横断面子研究（2016/17年）。暴露因素为平均每日娱乐性屏幕使用时间（电视、电脑、平板电脑、手机、电子游戏）。结局指标为儿童总体行为和亲社会行为，以及心理社会和生理HRQOL。采用多水平模型来检验：1）屏幕使用时间的绝对效应；2）当儿童自身屏幕使用时间相对于其同胞发生变化时儿童结局的变化（家庭内环境效应），以及当同胞平均屏幕使用时间发生变化时儿童结局的变化（家庭间环境效应）。这些儿童的平均年龄为7.37岁（标准差2.76）。屏幕使用时间对行为和HRQOL有绝对效应。发现家庭间效应存在于儿童总体行为（0·22（95%CI，0.06，0.37））和亲社会行为（-0.10（-0.17，-0.04））方面，但不存在家庭内效应。对于HRQOL，发现家庭内效应存在于心理社会（-0.97（-1.91，-0.02））和生理（-1.32（-2.25，-0.39））HRQOL方面，但未发现家庭间效应。总之，家庭中所有儿童的平均屏幕使用时间越高，儿童的行为越差，而儿童屏幕使用时间与其同胞的差异越大，其HRQOL越差。在屏幕使用时间研究和屏幕使用时间建议中应考虑家庭环境因素。
