Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Research

Association between screen time and physical activity on mental health among preschoolers: a cross-sectional study from Southwest China

Authors: Yi Liang, Qiyun Jin, Junjie Miao, Xiaorong Ni, Xiaoxiao Qian, Yi Xiong, Zhijun Liu, Hongmei Xue

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

Screen time and physical activity behaviors undergo development during early childhood and impact mental health. However, there is limited knowledge regarding the associations between physical activity, screen time, and mental health problems (MHP) in preschoolers. This study examines these associations using a large sample size and brief measures.

Methods

A multistage cluster stratified sampling method was used to conduct an observational cross-sectional study of 19,015 Chinese preschoolers in 2020. Information on physical activity, and screen time was collected by a self-administered questionnaire; MHP was assessed by the parent-reported Strengths and Difficulties Questionnaire (SDQ). Logistic regression models were used to obtain the odds ratios (ORs) and 95% confidence intervals (95% CIs) of preschoolers’ MHP associated with screen time, total physical activities, moderate to vigorous physical activity (MVPA), and outdoor physical activities.

Results

A total of 19,015 participants from the 19,548 recruited population were included in the analyses (missing rate: 2.73%), 52.60% were boys. 64.01%, 57.96%, 35.98%, and 82.64% of preschoolers were reported to meet total physical activities, MVPA, and outdoor activities with screen time recommendations level. The results of multivariable-adjusted ORs (95% CIs) of preschoolers’ MHP for comparisons of different levels of screen time (< 2 h/day, 2–4 h/day,≥4 h/day) show that screen time positively associated with MHP after adjusting for confounders (P < 0.05), but the association was not significant among girls with screen time ≥ 4 h/day. In addition, increased engagement in physical activity was reversely linked to MHP (P < 0.05). A stronger association between MHP and MVPA was observed in boys, however, this association was weakened when the total time spent engaging in MVPA exceeded two hours per day (P < 0.05).

Conclusion

Less physical activity and more screen time positively relate to MHP, but the relationship differs by type of physical activity, total time, and gender. These findings provide novel insights and evidence supporting for guidelines on physical activity, screen time, and improvement of mental health for preschoolers.
Appendix
Available only for authorised users
Literature
1.
Klitzing Kv, Döhnert M, Kroll M, Grube M. Mental disorders in early childhood. Dtsch Arztebl Int. 2015;112(21–22):375.
2.
Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378(9801):1515–25.PubMedCrossRef
3.
Bor W, Dean AJ, Najman J, Hayatbakhsh R. Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Review. 2014;48(7):606–16.
4.
Charach A, Mohammadzadeh F, Belanger SA, et al. Identification of preschool children with mental health problems in primary care: systematic review and meta-analysis. J Can Acad Child Adolesc Psychiatry. 2020;29(2):76–105.PubMedPubMedCentral
5.
Li F, Cui Y, Li Y, Guo L, Ke X, Liu J, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17,524 individuals. Child Psychol Psychiatry. 2022;63(1):34–46.CrossRef
6.
Gleason MM, Goldson E, Yogman MW. Addressing early childhood emotional and behavioral problems. Pediatrics. 2016;138(6).
7.
Mierau JO, Kann-Weedage D, Hoekstra PJ, Spiegelaar L, Jansen DEMC, Vermeulen KM, et al. Assessing quality of life in psychosocial and mental health disorders in children: a comprehensive overview and appraisal of generic health related quality of life measures. BMC Pediatr. 2020;20(1):329.PubMedPubMedCentralCrossRef
8.
Kessler RC, Angermeyer M, Anthony JC, Demyttenaere RDEG, Gasquet K. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s world mental health survey initiative. World Psychiatry. 2007;6(3):168–76.PubMedPubMedCentral
9.
Ciarrochi J, Deane FP, Anderson S. Emotional intelligence moderates the relationship between stress and mental health. Pers Individ Dif. 2002;32(2):197–209.CrossRef
10.
Matza LS, Swensen AR, Flood EM, Secnik K, Leidy NK. Assessment of health-related quality of life in children: a review of conceptual, methodological, and regulatory issues. Value in Health. 2004;7(1):79–92.PubMedCrossRef
11.
Álvarez-Bueno C, Pesce C, Cavero-Redondo I, Sánchez-López M, Martínez-Hortelano JA, Martínez-Vizcaíno V. The effect of physical activity interventions on children’s cognition and metacognition: a systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2017;56(9):729–38.PubMedCrossRef
12.
Biddle SJ, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med. 2011;45(11):886–95.PubMedCrossRef
13.
Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: literature review and case study. Environ Res. 2018;164:149–57.PubMedCrossRef
14.
Liu Q, Zhou Y, Xie X, Xue Q, Zhu K, Wan Z, et al. The prevalence of behavioral problems among school-aged children in home quarantine during the COVID-19 pandemic in China. J Affect Disord. 2021;279:412–6.PubMedCrossRef
15.
Qin Z, Shi L, Xue Y, Lin H, Zhang J, Liang P, et al. Prevalence and risk factors associated with self-reported psychological distress among children and adolescents during the COVID-19 pandemic in China. JAMA Netw Open. 2021;4(1):e2035487–e.PubMedPubMedCentralCrossRef
16.
Brien K, Agostino J, Ciszek K, Douglas KA. Physical activity and risk of behavioral and mental health disorders in kindergarten children: analysis of a series of cross-sectional complete enumeration (census) surveys. BMJ Open. 2020;10(3):e034847.CrossRef
17.
Allen MS, Vella SA. Screen-based sedentary behavior and psychosocial well-being in childhood: cross-sectional and longitudinal associations. Ment Health Phys Act. 2015;9:41–7.CrossRef
18.
Hinkley T, Verbestel V, Ahrens W, Lissner L, Molnár D, Moreno LA, et al. Early childhood electronic media use as a predictor of poorer well-being: a prospective cohort study. Jama Pediatr. 2014;168(5):485–92.PubMedCrossRef
19.
Buckworth J, Nigg C. Physical activity, exercise, and sedentary behavior in college students. J Am Coll Health. 2004;53(1):28–34.PubMedCrossRef
20.
Trinh L, Wong B, Faulkner GE. The independent and interactive associations of screen time and physical activity on mental health, school connectedness and academic achievement among a population-based sample of youth. J Can Acad Child Adolesc Psychiatry. 2015;24(1):17.PubMedPubMedCentral
21.
Sampasa-Kanyinga H, Colman I, Goldfield GS. Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: a systematic review. Int J Behav Nutr Phys Act. 2020;17(1):72.PubMedPubMedCentralCrossRef
22.
Babic MJ, Morgan PJ, Plotnikoff RC, Lonsdale C, White RL, Lubans DR. Physical activity and physical self-concept in youth: systematic review and meta-analysis. Sports Med. 2014;44(11):1589–601.PubMedCrossRef
23.
Lubans D, Richards J, Hillman C et al. Physical activity for cognitive and mental health in youth: a systematic review of mechanisms. Pediatrics. 2016;138(3).
24.
Ferreira-Vorkapic C, Feitoza JM, Marchioro M, Simões J, Kozasa E, Telles S. Are there benefits from teaching yoga at schools? A Systematic Review of Randomized Control Trials of Yoga-Based Interventions. Evid Based Complement Alternat Med. 2015;(2015).
25.
Guan HY, Zhao X, Qu S, Wu J, Yang Y, Guo J, Zhang T, Luo D. Physical activity guideline for Chinese preschoolers aged 3–6 years. Chin J Child Health Care. 2020;28:714–20.
26.
Liu W, Wu X, Huang K, Yan S, Ma L, Cao H, et al. Early childhood screen time as a predictor of emotional and behavioral problems in children at 4 years: a birth cohort study in China. Environ Health Prev Med. 2021;26(1):3.PubMedPubMedCentralCrossRef
27.
Theunissen MH, Vogels AG, de Wolff MS, Reijneveld SAJP. Characteristics of the strengths and difficulties questionnaire in preschool children. Pediatrics. 2013;131(2):e446–e54.PubMedCrossRef
28.
Liu S-K, Chien Y-L, Shang C-Y, Lin C-H, Liu Y-C, Gau SS-F. Psychometric properties of the Chinese version of strength and difficulties questionnaire. Compr Psychiatry. 2013;54(6):720–30.PubMedCrossRef
29.
Goodman R. The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581–6.PubMedCrossRef
30.
Committee on Public E. Children, adolescents, and television. Pediatrics. 2001;107(2):423–6.CrossRef
31.
Bufferd SJ, Dougherty LR, Carlson GA, Rose S, Klein DN. Psychiatric disorders in preschoolers: continuity from ages 3 to 6. Am J Psychiatry. 2012;169(11):1157–64.PubMedPubMedCentralCrossRef
32.
Comacchio C, Antolini G, Ruggeri M, Colizzi M. Gender-oriented mental health prevention: a reappraisal. Int J Environ Res Public Health. 2022;19(3):1493.PubMedPubMedCentralCrossRef
33.
Wlodarczyk O, Pawils S, Metzner F, Kriston L, Wendt C, Klasen F, Ravens-Sieberer U, BELLA Study Group. Mental health problems among preschoolers in Germany: results of the BELLA preschool study. Child Psychiatry Hum Dev. 2016;47:529–38.PubMedCrossRef
34.
Tibber MS, Walji F, Kirkbride JB, Huddy V. The association between income inequality and adult mental health at the subnational level—a systematic review. Epidemiol Psichiatr Soc. 2022;57(1):1–24.CrossRef
35.
Purnawati E, Saraswati LD, Wurjanto MA, Yuliawati S. The effect of the covid-19 pandemic on mental health (children, adolescents, young adults) and mental health service: systematic review. Rev Saude Publica. 2022;11(2):179–97.
36.
Jin Q, Liang Y, Miao J, Xiong Y, Liu Z, Xue H, Li Z. Association between food intake and mental health problems among preschoolers in China. Front Public Health. 2022;10:1003416.PubMedPubMedCentralCrossRef
37.
Wang S-s, Lay S, Yu H-n. Shen S-rJJoZUSB. Dietary guidelines for Chinese residents (2016): comments and comparisons. Appetite. 2016;17(9):649.
38.
Van Dyk TR, Becker SP, Byars KC. Mental health diagnoses and symptoms in preschool and school age youth presenting to insomnia evaluation: prevalence and associations with sleep disruption. Behav Sleep Med. 2018;12(9):112–76.
39.
Owens JA, Spirito A, McGuinn, MJS-NY-. The children’s sleep habits questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep. 2000;23(8):1043–52.PubMedCrossRef
40.
Li H, Ji C-Y, Zong X-N, Zhang Y-Q. Body mass index growth curves for Chinese children and adolescents aged 0 to 18 years. Zhonghua Er Ke Za Zhi. 2009;47(7):493–8.PubMed
41.
Afifi M. Gender differences in mental health. Singap Med J. 2007;48(5):385.
42.
Biddle SJ, Ciaccioni S, Thomas G, Vergeer I. Physical activity and mental health in children and adolescents: an updated review of reviews and an analysis of causality. Psychol Sport Exerc. 2019;42:146.CrossRef
43.
Tandon PS, Zhou C, Johnson AM, Gonzalez ES, Kroshus E. Association of children’s physical activity and screen time with mental health during the COVID-19 pandemic. JAMA Netw Open. 2021;4:e2127892.PubMedPubMedCentralCrossRef
44.
Sagatun A, Søgaard AJ, Bjertness E, Selmer R, Heyerdahl SJB. The association between weekly hours of physical activity and mental health: a three-year follow-up study of 15–16-year-old students in the city of Oslo, Norway. BMC Public Health. 2007;7:1–9.CrossRef
45.
McCurdy LE, Winterbottom KE, Mehta SS, Roberts JR. Using nature and outdoor activity to improve children’s health. Curr Probl Pediatr Adolesc Health Care. 2010;40:102.PubMedCrossRef
46.
Yang L, Corpeleijn E, Hartman E. A prospective analysis of physical activity and mental health in children: the GECKO drenthe cohort. Int J Behav Nutr Phys Act. 2023;20:114.PubMedPubMedCentralCrossRef
47.
Buchan MC, Romano I, Butler A, Laxer RE, Patte KA, Leatherdale ST. Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study. Int J Behav Nutr Phys Act. 2021;18(1):1–1.CrossRef
48.
Bernard P, Dore I, Romain AJ, Hains-Monfette G, Kingsbury C, Sabiston C. Dose response association of objective physical activity with mental health in a representative national sample of adults: a cross-sectional study. PLoS ONE. 2018;13:e0204682.PubMedPubMedCentralCrossRef
49.
Werneck AO, Collings PJ, Barboza LL, Stubbs B, Silva DR. Associations of sedentary behaviors and physical activity with social isolation in 100,839 school students: the Brazilian scholar health survey. Gen Hosp Psychiatry. 2019;7:13.
50.
Cotman CW, Berchtold NC, Christie LA. Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends Neurosci. 2007;464:72.
51.
Liu W, Wu X, Huang K, Yan S, Ma L, Cao H, et al. Early childhood screen time as a predictor of emotional and behavioral problems in children at 4 years: a birth cohort study in China. Environ Health Prev Med. 2021;26:3.PubMedPubMedCentralCrossRef
52.
Wang X, Li Y, Fan H. The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis. BMC Public Health. 2019;1–9.
53.
Mougharbel F, Goldfield GS. Psychological correlates of sedentary screen time behaviour among children and adolescents: a narrative review. Curr Obes Rep. 2020;9:493.PubMedCrossRef
54.
Houghton S, Lawrence D, Hunter SC, Rosenberg M, Zadow C, Wood L, Shilton T. Reciprocal relationships between trajectories of depressive symptoms and screen media use during adolescence. J Youth Adolesc. 2018;47:2453.PubMedPubMedCentralCrossRef
55.
Li C, Cheng G, Sha T, Cheng W, Yan Y. The relationships between screen use and health indicators among infants, toddlers, and preschoolers: a meta-analysis and systematic review. Int J Environ Res Public Health. 2020;17:7324.PubMedPubMedCentralCrossRef
56.
Twenge JM, Farley E. Not all screen time is created equal: associations with mental health vary by activity and gender. Soc Psychiatry Psychiatr Epidemiol. 2021;56:207.PubMedCrossRef
57.
Twenge JM, Haidt J, Lozano J, Cummins KM. Specification curve analysis shows that social media use is linked to poor mental health, especially among girls. Acta Psychol. 2022;224:103512.CrossRef
58.
Edwards MK, Loprinzi PD. Experimentally increasing sedentary behavior results in increased anxiety in an active young adult population. J Affect Disord. 2016;166:73.
59.
Sampasa-Kanyinga H, Colman I, Goldfield GS, Janssen I, Wang J, Podinic I, et al. Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: a systematic review. Int J Behav Nutr Phys Act. 2020;1:6.
60.
Telama R, Yang X, Leskinen E, Kankaanpää A, Hirvensalo M, Tammelin T, et al. Tracking of physical activity from early childhood through youth into adulthood. Med Sci Sports Exerc. 2014;46(5):955–62.PubMedCrossRef
61.
Martin R, Murphy J, Molina-Soberanes D, Murtagh EM. The clustering of physical activity and screen time behaviours in early childhood and impact on future health-related behaviours: a longitudinal analysis of children aged 3 to 8 years. BMC Public Health. 2022;21:22:558.CrossRef
Metadata
Title
Association between screen time and physical activity on mental health among preschoolers: a cross-sectional study from Southwest China
Authors
Yi Liang
Qiyun Jin
Junjie Miao
Xiaorong Ni
Xiaoxiao Qian
Yi Xiong
Zhijun Liu
Hongmei Xue
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-17722-8

Other articles of this Issue 1/2024

BMC Public Health 1/2024 Go to the issue

Research

The long-term changing patterns of suicide mortality in China from 1987 to 2020: continuing urban-rural disparity

Research

The effect of physical fitness on psychological health: evidence from Chinese university students

Research

Health literacy of trans and gender diverse individuals –a cross sectional survey in Germany

Research

Interventions for the detection, monitoring, and management of chronic non-communicable diseases in the prison population: an international systematic review

Research

Awareness and knowledge of drug decriminalization among people who use drugs in British Columbia: a multi-method pre-implementation study

Research article

Food budget ratio as an equitable metric for food affordability and insecurity: a population-based cohort study of 121 remote Indigenous communities in Canada