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Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

The mediating role of the home environment in relation to parental educational level and preschool children’s screen time: a cross-sectional study

Authors: Suvi Määttä, Riikka Kaukonen, Henna Vepsäläinen, Elviira Lehto, Anna Ylönen, Carola Ray, Maijaliisa Erkkola, Eva Roos

Published in: BMC Public Health | Issue 1/2017

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Abstract

Background

Previous studies suggest that preschoolers from low socioeconomic backgrounds engage in more screen time. Still, the factors in the social and physical home environment driving these differences in preschool children’s screen time are poorly understood. This study examines potential home environment mediators in the associations between parental educational level and preschoolers’ screen time.

Methods

A total of 864 children aged 3–6 years and their parents participated in a cross-sectional DAGIS study in 2015–2016. Parents recorded their children’s screen time in a diary (N = 823). For the analyses, the daily average screen time at home was calculated. Parental questionnaires (N = 808) assessed educational level and eight social and physical environment factors in the home (i.e., descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, parental attitude toward societal pressures for children’s screen time, access to screens at home, parental self-efficacy for limiting children’s screen time, satisfaction of children’s screen time, and rules for limiting children’s screen time). Parental education was grouped into low, middle, and high education. The associations were tested by conducting mediation analyses adjusted by season and children’s sex and age. The significant mediators in the single-mediator models were included in the final multiple-mediator models.

Results

Of the potential eight mediators, the following four had a significant indirect association: descriptive norm for children’s screen time, parental screen use in front of children, parental importance for limiting children’s screen time, and parental attitude toward societal pressures for children’s screen time. Parents with high education had lower descriptive norm and used fewer screens in front of children compared to parents with middle or low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level. Parents with high education placed greater importance on limiting children’s screen time and felt less societal pressures about children’s screen time compared to parents with low education, and in turn, these factors were associated with less screen time among children from parents with a higher education level.

Conclusions

Our study recognized multiple modifiable mediators in the associations between parental education and preschool children’s screen time. When aiming to diminish socioeconomic status differences in preschool children’s screen time, the focus should be on parental role models, attitudes, and norm related to children’s screen time.
Literature
1.
2.
3.
De Craemer M, Lateva M, Iotova V, De Decker E, Verloigne M, De Bourdeaudhuij I, Androutsos O, Socha P, Kulaga Z, Moreno L, Koletzko B, Manios Y, Cardon G. ToyBox-study group: differences in energy balance-related behaviours in European preschool children: the ToyBox-study. PLoS One. 2015;10(3):e0118303.CrossRefPubMedPubMedCentral
4.
Downing KL, Hinkley T, Salmon J, Hnatiuk JA, Hesketh KD: Do the correlates of screen time and sedentary time differ in preschool children? BMC Public Health 2017, 17(1):285–017-4195-x.
5.
Hinkley T, Carson V, Kalomakaefu K, Brown H. What mums think matters: a mediating model of maternal perceptions of the impact of screen time on preschoolers' actual screen time. Prev Med Rep. 2017;6:339–45.CrossRefPubMedPubMedCentral
6.
Cameron AJ, Spence AC, Laws R, Hesketh KD, Lioret S, Campbell KJ. A review of the relationship between socioeconomic position and the early-life predictors of obesity. Curr Obes Rep. 2015;4(3):350–62.CrossRefPubMed
7.
Loprinzi PD, Schary DP, Cardinal BJ. Adherence to active play and electronic media guidelines in preschool children: gender and parental education considerations. Matern Child Health J. 2013;17(1):56–61.CrossRefPubMed
8.
van Rossem L, Vogel I, Moll HA, Jaddoe VW, Hofman A, Mackenbach JP, Raat H. An observational study on socio-economic and ethnic differences in indicators of sedentary behavior and physical activity in preschool children. Prev Med. 2012;54(1):55–60.CrossRefPubMed
9.
Wijtzes AI, Jansen W, Kamphuis CB, Jaddoe VW, Moll HA, Tiemeier H, Verhulst FC, Hofman A, Mackenbach JP, Raat H. Increased risk of exceeding entertainment-media guidelines in preschool children from low socioeconomic background: the generation R study. Prev Med. 2012;55(4):325–9.CrossRefPubMed
10.
Carson V, Kuzik N, Hunter S, Wiebe SA, Spence JC, Friedman A, Tremblay MS, Slater LG, Hinkley T. Systematic review of sedentary behavior and cognitive development in early childhood. Prev Med. 2015;78:115–22.CrossRefPubMed
11.
Hinkley T, Teychenne M, Downing KL, Ball K, Salmon J, Hesketh KD. Early childhood physical activity, sedentary behaviors and psychosocial well-being: a systematic review. Prev Med. 2014;62:182–92.CrossRefPubMed
12.
LeBlanc AG, Spence JC, Carson V, Connor Gorber S, Dillman C, Janssen I, Kho ME, Stearns JA, Timmons BW, Tremblay MS. Systematic review of sedentary behaviour and health indicators in the early years (aged 0-4 years). Appl Physiol Nutr Metab. 2012;37(4):753–72.CrossRefPubMed
13.
14.
Sallis JF, Owen N, Fisher EB: Ecological models of health behavior. In Health behavior and health education: theory, research, and practice. 4th ed. edition. Edited by Glanz K, Rimer BK, Viswanath Ke. San Francisco CA: Jossey-Bass; 2008:465–482.
15.
Papoutsi GS, Drichoutis AC, Nayga J. R.M.: the causes of childhood obesity: a survey. J Econ Surv. 2013;27(4):743–64.CrossRef
16.
Jago R, Wood L, Zahra J, Thompson JL, Sebire SJ. Parental control, nurturance, self-efficacy, and screen viewing among 5- to 6-year-old children: a cross-sectional mediation analysis to inform potential behavior change strategies. Child Obes. 2015;11(2):139–47.CrossRefPubMedPubMedCentral
17.
De Craemer M, De Decker E, De Bourdeaudhuij I, Vereecken C, Deforche B, Manios Y, Cardon G. ToyBox-study group: correlates of energy balance-related behaviours in preschool children: a systematic review. Obes Rev. 2012;13(Suppl 1):13–28.CrossRefPubMed
18.
Tandon P, Grow HM, Couch S, Glanz K, Sallis JF, Frank LD, Saelens BE. Physical and social home environment in relation to children's overall and home-based physical activity and sedentary time. Prev Med. 2014;66:39–44.CrossRefPubMedPubMedCentral
19.
Gebremariam MK, Altenburg TM, Lakerveld J, Andersen LF, Stronks K, Chinapaw MJ, Lien N. Associations between socioeconomic position and correlates of sedentary behaviour among youth: a systematic review. Obes Rev. 2015;16(11):988–1000.CrossRefPubMed
20.
Glymour MM, Avendano M, Kawachi I: Socioeconomic status and health. In Social epidemiology. 2nd edition. Edited by Berkman LF, Kawachi I, Glymour MM. New York: Oxford University Press; 2014:17–62.
21.
Mantziki K, Vassilopoulos A, Radulian G, Borys JM, Du Plessis H, Gregorio MJ, Graca P, De Henauw S, Handjiev S, Visscher TL, Seidell JC: Inequities in energy-balance related behaviours and family environmental determinants in European children: baseline results of the prospective EPHE evaluation study. BMC Public Health 2015, 15:1203–015–2540-5.
22.
Tandon PS, Zhou C, Lozano P, Christakis DA. Preschoolers' total daily screen time at home and by type of child care. J Pediatr. 2011;158(2):297–300.CrossRefPubMed
23.
Biddle SJ, Pearson N, Ross GM, Braithwaite R. Tracking of sedentary behaviours of young people: a systematic review. Prev Med. 2010;51(5):345–51.CrossRefPubMed
24.
McVeigh JA, Zhu K, Mountain J, Pennell CE, Lye SJ, Walsh JP, Straker LM. Longitudinal trajectories of television watching across childhood and adolescence predict bone mass at age 20 years in the Raine study. J Bone Miner Res. 2016;
25.
Jones RA, Hinkley T, Okely AD, Salmon J. Tracking physical activity and sedentary behavior in childhood: a systematic review. Am J Prev Med. 2013;44(6):651–8.CrossRefPubMed
26.
Määttä S, Lehto R, Nislin M, Ray C, Erkkola M, Sajaniemi N, Roos E. Increased health and wellbeing in preschools (DAGIS): rationale and design for a randomized control. BMC Public Health. 2015;15(1):402.CrossRefPubMedPubMedCentral
27.
28.
Wen LM, van der Ploeg HP, Kite J, Cashmore A, Rissel C. A validation study of assessing physical activity and sedentary behavior in children aged 3 to 5 years. Pediatr Exerc Sci. 2010;22:408.CrossRefPubMed
29.
Carson V, Janssen I: Associations between factors within the home setting and screen time among children aged 0–5 years: a cross-sectional study. BMC Public Health 2012, 12:539–2458–12-539.
30.
Crawford DA, Ball K, Cleland VJ, Campbell KJ, Timperio AF, Abbott G, Brug J, Baur LA, Salmon JA. Home and neighbourhood correlates of BMI among children living in socioeconomically disadvantaged neighbourhoods. Br J Nutr. 2012;107(7):1028–36.CrossRefPubMed
31.
Pinard CA, Yaroch AL, Hart MH, Serrano EL, McFerren MM, Estabrooks PA. The validity and reliability of the comprehensive home environment survey (CHES). Health Promot Pract. 2014;15(1):109–17.CrossRefPubMed
32.
Määttä S, Ray C, Roos G, Roos E. Applying a socioecological model to understand preschool Children’s sedentary behaviors from the viewpoints of parents and preschool personnel. Early Childhood Educ J. 2016;44(5):491–502.CrossRef
33.
Ray C, Määttä S, Roos G, Roos E. Vanhempien käsityksiä päiväkoti-ikäisten lasten kasvisten, hedelmien ja sokeripitoisten elintarvikkeiden syömiseen vaikuttavista tekijöistä [parents perceptions about factors influencing preschool children’s intake of fruit and vegetables, and sugar-enriched foods]. Varhaiskasvatuksen Tiedelehti (Journal of Early Childhood Education Research). 2016;5(1):115–35.
34.
Ray C, Kalland M, Lehto R, Roos E. Does parental warmth and responsiveness moderate the associations between parenting practices and children's health-related behaviors? J Nutr Educ Behav. 2013;45(6):602–10.CrossRefPubMed
35.
Ray C, Roos E. Family characteristics predicting favourable changes in 10 and 11-year-old children's lifestyle-related health behaviours during an 18-month follow-up. Appetite. 2012;58(1):326–32.CrossRefPubMed
36.
Gonzalez-Gil EM, Mouratidou T, Cardon G, Androutsos O, De Bourdeaudhuij I, Gozdz M, Usheva N, Birnbaum J, Manios Y, Moreno LA. ToyBox-study group: reliability of primary caregivers reports on lifestyle behaviours of European pre-school children: the ToyBox-study. Obes Rev. 2014;15(Suppl 3):61–6.CrossRefPubMed
37.
Cerin E, MacKinnon DP. A commentary on current practice in mediating variable analyses in behavioural nutrition and physical activity. Public Health Nutr. 2009;12(8):1182–8.CrossRefPubMed
38.
Rucker DD, Preacher KJ, Tormala ZL, Petty RE. Mediation analysis in social psychology: current practices and new recommendations. Soc Personal Psychol Compass. 2011;5(6):359–71.CrossRef
39.
Bentley GF, Turner KM, Jago R: Mothers’ views of their preschool child’s screen-viewing behaviour: a qualitative study. BMC Public Health 2016, 16(718).
40.
Evans CA, Jordan AB, Horner J. Only two hours? A qualitative study of the challenges parents perceive in restricting child television time. J Fam Issues. 2015;32(9):1223–44.CrossRef
41.
42.
Lampard AM, Jurkowski JM, Lawson HA, Davison KK. Family ecological predictors of physical activity parenting in low-income families. Behav Med. 2013;39(4):97–103.CrossRefPubMedPubMedCentral
43.
Dumuid D, Olds TS, Lewis LK, Maher C: Does home equipment contribute to socioeconomic gradients in Australian children's physical activity, sedentary time and screen time? BMC Public Health 2016, 16:736–016–3419-9.
44.
Tandon PS, Zhou C, Sallis JF, Cain KL, Frank LD, Saelens BE: Home environment relationships with children's physical activity, sedentary time, and screen time by socioeconomic status. Int J Behav Nutr Phys Act 2012, 9:88–5868–9-88.
45.
Heilmann A, Rouxel P, Fitzsimons E, Kelly Y, Watt R: Longitudinal associations between television in the bedroom and body fatness in a UK cohort study. International Journal of Obesity 2017,:1–7.
46.
Hesketh K, Ball K, Crawford D, Campbell K, Salmon J. Mediators of the relationship between maternal education and children's TV viewing. Am J Prev Med. 2007;33(1):41–7.CrossRefPubMed
47.
Downing K, Hnatiuk J, Hinkley T, Salmon J, Hesketh K. Interventions to reduce sedentary behaviour in 0–5-year-olds: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2016;
48.
Jago R, Edwards M, Urbanski CR, Sebire SJ: General and specific approaches to media parenting: a systematic review of current measures, associations with screen-viewing, and measurement implications. Childhood Obesity 2013, 9(Supplement):51–72.
49.
50.
Granich J, Rosenberg M, Knuiman M, Timperio A. Understanding children's sedentary behaviour: a qualitative study of the family home environment. Health Educ Res. 2010;25(2):199–210.CrossRefPubMed
51.
Jago R, Stamatakis E, Gama A, Carvalhal IM, Nogueira H, Rosado V, Padez C. Parent and child screen-viewing time and home media environment. Am J Prev Med. 2012;43(2):150–8.CrossRefPubMed
52.
Schoeppe S, Rebar AL, Short CE, Alley S, Van Lippevelde W, Vandelanotte C: How is adults' screen time behaviour influencing their views on screen time restrictions for children? A cross-sectional study. BMC Public Health 2016, 16:201–016–2789-3.
53.
Sanders W, Parent J, Forehand R, Sullivan AD, Jones DJ. Parental perceptions of technology and technology-focused parenting: associations with youth screen time. J Appl Dev Psychol. 2016;44:28–38.CrossRefPubMedPubMedCentral
54.
Pinket AS, De Craemer M, De Bourdeaudhuij I, Deforche B, Cardon G, Androutsos O, Koletzko B, Moreno LA, Socha P, Iotova V, Manios Y, Van Lippevelde W: Can Parenting Practices Explain the Differences in Beverage Intake According to Socio-Economic Status: The Toybox-Study. Nutrients 2016, 8(10):https://​doi.​org/​10.​3390/​nu8100591.
55.
Schmidt ME, Haines J, O'Brien A, McDonald J, Price S, Sherry B, Taveras EM. Systematic review of effective strategies for reducing screen time among young children. Obesity (Silver Spring). 2012;20(7):1338–54.CrossRef
56.
57.
Altenburg TM, Kist-van Holthe J, Chinapaw MJ: Effectiveness of intervention strategies exclusively targeting reductions in children's sedentary time: a systematic review of the literature. Int J Behav Nutr Phys Act 2016, 13:65–016–0387-5.
58.
Field A. Discovering statistics using SPSS: 3rd ed. London: Sage Publications; 2009.
59.
Hayes A. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach: the Guilford press. New York; 2014.
60.
Mielke GI, Brown WJ, Nunes BP, Silva IC, Hallal PC. Socioeconomic correlates of sedentary behavior in adolescents: systematic review and meta-analysis. Sports Med. 2017;47(1):61–75.CrossRefPubMed
61.
Bryant M, Lucove J, Evenson K, Marshall S. Measurement of television viewing in children and adolescents: a systematic review. Obes Rev. 2007;8(3):197–209.CrossRefPubMed
Metadata
Title
The mediating role of the home environment in relation to parental educational level and preschool children’s screen time: a cross-sectional study
Authors
Suvi Määttä
Riikka Kaukonen
Henna Vepsäläinen
Elviira Lehto
Anna Ylönen
Carola Ray
Maijaliisa Erkkola
Eva Roos
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4694-9

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