title: Prevalence and correlates of screen time in youth: an international perspective.
abstract: BACKGROUND
  Screen time (including TV viewing/computer use) may be adversely associated with metabolic and mental health in children.
  
  
  OBJECTIVE
  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.
authors.affiliation: MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom. Electronic address: aa595@medschl.cam.ac.uk.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Atkin
authors.affiliation: MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Sharp
authors.affiliation: MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Corder
authors.affiliation: MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
authors.forename: Esther M F
authors.initials: EM
authors.lastname: van Sluijs
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology / Q000502:physiology; D001292:Attitude to Computers / Q000208:ethnology*; D002648:Child; D002652:Child Behavior / Q000208:ethnology / Q000502:physiology; D002675:Child, Preschool; D003201:Computers / Q000706:statistics & numerical data*; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D008603:Mental Health; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013690:Television / Q000706:statistics & numerical data*; D013997:Time Factors