EVIDENCE BASED TABLE FORM

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EVIDENCE BASED TABLE FORM

Samuel Allen

 

Article numberTitle of article, Author, Year

 

SettingSample Size and TypeLevel of EvidenceStudy FindingsLimitationsOutcomesOther info
1Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptom and other mental health problems in children and adolescents: a systematic review

 

Year: 2020

 

Authors: Sampasa-Kanyinga, H., Colman, I., Goldfield, G. S., Janssen, I., Wang, J., Podinic, I., Tremblay, M. S., Saunders, T. J., Sampson, M., & Chaput, J.-P.

 

School of Epidemiology and Public Health & Healthy Acute Living and Obesity Research Group in Canada13 cross sectional studies. Involved 115,540 children and adolescents in 12 countries.

 

Inclusion criteria involved all three:

Physical activity, sedentary time, and sleep duration

1If they met all three inclusion criteria it was associated with significantly lower odds of depression among adolescents compared with meeting one or any combination of two of them.

 

Excessive screen time and mental health problems may be direct or indirect. Direct pathways can affect interpersonal relationships or direct cognitive effects creating low emotional stability. Indirect pathways could be observed through insufficient sleep, and unhealthy eating habits.

The articles used for this study were only published in English or French.

 

Many of the studies only used a single item measure of mental health problems (e.g., depressive symptoms) which could raise validity and reliability issues.

 

The quality of evidence assessed using GRADE was “very low” quality mainly because of cross sectional nature.

The findings are favorable between meeting all three recommendations and better mental health among children and adolescents when compared with meeting none of the recommendations.

 

Meeting the screen time and sleep duration recommendations appeared to be associated with more mental health benefits then meeting the physical activity recommendation.

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2Screen time and Mental Health Among Adolescents Implications of the Rise in Digital Environment in South Africa

 

Year: 2022

 

Authors: Ranjit, K., Ntlantsana, V., Tomita, A., & Paruk, S.

Three public school in South Africa187 students of whom most were female (142) from grades 8 to 11.

 

Cross sectional study, descriptive, quantitative, self-administered questionnaire.

IVFifty participants (27.9%) reported depressive symptoms with PHQ-9 of 5-9, 29 (16.2%) had scores from 10-14, and 21 (11.7%) had scores of 15 or more indicating severe depression.

 

Found higher overall screen time to be significantly associated with greater likelihood of depression

 

Mean screen time during the weekdays were 2.1 hours/day and mean screen time during the weekend was 4.7 hours/day

Include the cross sectional design which only assessed screen use at one point but may change with circumstances, such as the pandemic lockdown period.

 

Sample size was limited and a low response /attrition rate.

 

Self-reporting by participates may be subjective and include underreporting or over reporting of screen time and depressive symptoms

Found a significant role of screen time during the weekend on depression and conduct symptoms.

 

Also found out that greater weekend cell phone use was significantly associated with lower prosocial behaviors.

n/a
3Association of Children’s Physical Activity and Screen Time with Mental Health During the COVID-19 Pandemic

 

Year: 2021

 

Authors: Tandon, P.S., Zhou, C., Johnson, A. M., Gonzalez, E. S., & Kroshus, E.

A market research company (YouGov)

By the institutional review board of Seattle Children Hospital in Seattle Washington

1000 school aged children from 11-17

 

A cross – sectional study using the test-retest reliability

IVAverage age of the study was 11 with 517 (52.6%) being boys and 467 (47.4%) girls.

 

Overall 143 children (13.7%) were diagnosed or undergoing evaluation for anxiety; 110 (10.4%) for depression; 160 (15.0%) for ADHD & 116(11.4%) a behavioral problem.

 

Only 24% of children in this study met the recommendation for 60 minutes per day of physical activity.

Include the fact that all data were collected by the parent or child report and are subject to biases

 

Unable to discern whether mental health diagnoses started before or during the pandemic.

More physical activity and less screen time were associated with better mental health for children accounting for the stressors of the pandemic.

Children who were exposed to more pandemic related stressors engaged in less physical activity and more screen time then peers who were less exposed.

n/a
4Screen Time Use Among US Adolescents During the COVID- 19 Pandemic

 

Year: 2022

 

Authors: Jason Nagata MD, Catherine Cortez, Chloe Cattle, Kyle Ganson PHD, Puja Iyer, Kirsten Bibbins-Domingo PHD & Fiona C. Baker PHD.

Online; COVID-19 Response Research Release from the Adolescent Brain Cognitive Development obtained from the University of California, San Diego5412 adolescents included in the sample

Including 50.7% female and 49.3% male as well as racial and ethically diverse.

 

A cross sectional study

IVAdolescents reported a mean of 7.70 (5.74) hours/day of screen use, mostly spent on watching or streaming videos, movies or television shows (2.45 hours/day), multiple player gaming (2.21 hours/day, and single player gaming (1.82 hours/day).

 

 

Limitations involve whether this greater mental health disparities are partly driven by assess to financial resources and digital media education.

 

Limitations also include the use of self-reported data.

Poorer mental health and greater perceived stress were associated with higher total screen use, while more social support and coping behaviors were associated with lower total screen use.n/a
5Impact on adolescent mental health of replacing screen-use with exercise: A prospective cohort study

 

Year: 2022

 

Authors: AaronKandola, Borja del Pozo Cruz, Joseph F. Hayes Neville Owen David W. Dunstan, & Mats Hallgren

 

They used time-use diary data at age 14 to estimate daily screen use (television, social media, & video games) and exercise (team sport and individual exercise). The outcome

was emotional distress at age 17, assessed using the emotional symptoms subscale of the

Strengths and Difficulties Questionnaire.

4,599 adolescents (55% female)

at the age of 14 years old.

 

A prospective cohort/

longitudinal study

IVTheoretically replacing 60 minutes of total screen time with exercise at age 14 was associated

with a 0.05 (95%CI -0.08, -0.02) score reduction on the emotional symptoms’ subscale at 17in fully-adjusted models. Replacing 60 minutes of television or social media use with team

sports was associated with a reduction of 0.17 (95%CI, -0.31, -0.04) and 0.15 (95%CI, -0.29,

-0.01) in emotional symptom scores, respectively. We found no change in emotional

symptom scores when replacing video game or general computer use with team sport, or when replacing any screen time with individual exercise.

No direct measure of depressive symptoms at follow-up.Replacing any screen time with exercise could reduce emotional distress, but the largest effect sizes were associated with replacing time in television watching and social media with team sports. Recommendations to limit screen-use in adolescents may require a nuanced

approach for protecting mental health.

n/a
6Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study.

 

Year: 2018

 

Authors: Jean Twenge & Keith Campbell

Based on the 2016 census random families were selected and survey was administered online or in paper44, 734 children between the ages of 2-17 years of age

 

It is cross sectional randomized population based study

IVAmong 14- to 17-year-olds, high users of screens (7+ h/day vs. low users of 1 h/day) were more than twice as likely to ever have been diagnosed with

depression (RR 2.39, 95% CI 1.54, 3.70), ever diagnosed with anxiety (RR 2.26, CI 1.59, 3.22), treated by a mental health professional (RR 2.22, CI 1.62, 3.03) or have taken medication for a psychological or behavioral issue (RR 2.99, CI 1.94, 4.62) in the last 12 months. M

First, screen time was

reported by caregivers and not the children or adolescents themselves.

 

Also, the well-being

measures may be influenced by caregivers’ perceptions and may under-

report issues that children do not disclose to their parents.

After 1 h/day of use, more hours of daily screen time were associated with lower psychological well-being,

including less curiosity, lower self-control, more distractibility, more difficulty making friends, less emotional stability, being more difficult to care for, and inability

to finish tasks.

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References:

Kandola, A. Pozo Cruz, B., Hayes, J. F., Owen, N., Dunstan, D. W. & Hallgren, M. (2021). Impact on adolescent mental health of replacing screen-use with exercise: A prospective cohort study. Journal of Affective Disorders 301, 240-247. https://doi.org/10.1016/j.jad.2021.12.064

Nagata, J. M., Cortez, C. A., Cattle, C. J., Ganson, K. T., Iyer, P., Bibbins-Domingo, K., & Baker, F. C. (2022). Screen Time Use Among US Adolescents During the COVID-19 Pandemic: Findings From the Adolescent Brain Cognitive Development (ABCD) Study. JAMA Pediatrics, 176(1), 94–96. https://doi.org/10.1001/jamapediatrics.2021.4334

Ranjit, K., Ntlantsana, V., Tomita, A., & Paruk, S. (2022). Screen Time and Mental Health Among Adolescents: Implications of the Rise in Digital Environment in South Africa. Journal of Nervous & Mental Disease, 210(6), 454–461. https://doi-org.10.1097/NMD.0000000000001509

Sampasa-Kanyinga, H., Colman, I., Goldfield, G. S., Janssen, I., Wang, J., Podinic, I., Tremblay, M. S., Saunders, T. J., Sampson, M., & Chaput, J.-P. (2020). 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. International Journal of Behavioral Nutrition & Physical Activity, 17(1), 1–16. https://doi-org.10.1186/s12966-020-00976

Tandon, P. S., Zhou, C., Johnson, A. M., Gonzalez, E. S., & Kroshus, E. (2021). Association of Children’s Physical Activity and Screen Time With Mental Health During the COVID-19 Pandemic. JAMA Network Open, 4(10), e2127892. https://doi-org./10.1001/jamanetworkopen.2021.27892

Twenge, J. M., & Campbell, W. K. (2018). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventive Medicine Reports, 12, 271–283. https://doi.org/10.1016/j.pmedr.2018.10.003

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