A Program for Parents’ Screen Time Reduction for Preschool Children: A Quasi-experimental Study

Authors

  • Wisanee Boonmun Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital and Faculty of Nursing, Mahidol University, Thailand.
  • Rutja Phuphaibul Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital and Faculty of Nursing, Mahidol University, Thailand.
  • Sirichai Hongsanguansri Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Apawan Nookong Faculty of Nursing, Mahidol University, Thailand.
  • Natkamol Chansatitporn Faculty of Public Health, Mahidol University, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2023.260440

Keywords:

Ajzen’s Theory of Planned Behavior, Intention, Parent training program, Preschool children, Screen time reduction

Abstract

Excessive screen time affects the development and health outcomes among children. This quasi-experimental study examined the effects of the newly developed Parents’ Screen Time Reduction for Preschool Children Program, a training program for parents’ planned behaviors and the screen time reduction of their children. The participants were dyads of parents and preschool children aged 2-5 years, where the child’s screen time was more than one hour per day. Sixty-seven parents were recruited from two childcare centers in a province in northeast Thailand, comprising 35 in the experimental group and 32 in the control group. Instruments to measure study outcomes focused on parents’ attitudes, subjective norms, perceived behavioral control, and intentions, and the distal result was behaviors. For children, the outcome was screen time reduction. Data analyses were descriptive statistics, chi-square, independent t-test, Mann-Whitney U test, and generalized estimating equations.

The findings revealed that the children’s screen time in the experimental group decreased significantly more at one week and two months after the completion of the intervention than that of the control group. The mean scores of parents’ attitudes and parents’ behaviors in the experimental group were significantly more positive higher than those in the control
group immediately after the intervention; the mean score of parents’ perceived behavior control was significantly higher than that of the control group two months after the intervention. Nurses and teachers can use this program among parents to perform appropriate screen time behaviors to promote development and health outcomes among children. However, further testing of the program using randomized controlled trials is required before widespread use in practice.

References

World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age [Internet]. 2019 [cited 2022 Jan 12]. Available from: https://apps.who.int/iris/handle/10665/311664.

Thai Health Project. 10 indicators on early childhood health. Nakorn Pathom: Institute for Population and Social Research, Mahidol University [Internet]. 2018 [cited 2021 Feb 10]. Available from: http://www.thaihealth report.com

Chumprasert T, Wiroonpanich W, Wattanasit P. Relationships between the use of electronic media and the development of children aged 2-5 years in public child development centers in Songkhla province. SCNJ. 2019;6(2):91-104 (in Thai).

Kumruangrit S, Tansuwat R, Marat S, Phothiwichit L, Phichitsiri N. Smart devices and family roles: a study of smart device use among children aged 2-5 in Thailand’s health region 3. JPSS. 2022;30:72-85 (in Thai).

American Academy of Pediatrics. Council on communications and media. Media use in school-aged children and adolescents. Pediatrics. 2016;138(5):e20162592. doi: 10.1542/ peds.2016-2592.

The Royal College of Pediatricians of Thailand. Manual for parents to publish knowledge about child care and development in early childhood 0-3 years of age [Internet]. 2020 [cited 2022 Feb 15]. Available from: https://www. thaipediatrics.org (in Thai)

Anderson DR, Subrahmanyam K. Digital screen media and cognitive development. Pediatrics. 2017;140(Suppl 2):S57-61. doi: 10.1542/peds.2016-1758C.

Canadian Paediatric Society, Digital Health Task Force, Ottawa, Ontario. Screen time and young children: promoting health and development in a digital world. Paediatr Child Health. 2017;22(8):461-8. https://doi.org/10. 1093/ pch/pxx123

Madigan S, Browne D, Racine N, Mori C, Tough S. Association between screen time and children’s performance on a developmental screening test. JAMA Pediatr 2019; 173(3):244-50. doi: 10.1001/jamapediatrics. 2018. 5056.

Tansriratanawong S, Louthrenoo O, Chonchaiya W, Charnsil C. Screen viewing time and externalising problems in preschool children in Northern Thailand. Child Adolesc Ment Health. 2017;29(3):245-52 (in Thai).

Reyna-Vargas ME, Parmar A, Lefebvre DL, Azad MB, Becker AB, Turvey SE, et al. Longitudinal associations between sleep habits, screen time and overweight, obesity in preschool children. Nat Sci Sleep. 2022;14(5):1237-47. doi: 10.2147/NSS.S363211

Lan QY, Chan KC, Kwan NY, Chan NY, Wing YK, Li AM, et al. Sleep duration in preschool children and impact of screen time. Sleep Med 2020;76:48-54. https://doi. org/10.1016/j.sleep.2020.09.024

Wu X, Tao S, Rutayisire E, Chen Y, Huang K, Tao F. The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China. Eur Child Adolesc Psychiatry. 2017;26(5):541–8. https://doi.org/10.1007/s00787-016-0912-8

Limtrakul N, Louthrenoo O, Narkpongphun A, Boonchooduang N, Chonchaiya W. Media use and psychosocial adjustment in children and adolescents. J Paediatr Child Health. 2018;54(3):296-301. doi:10. 1111/jpc.13725.

Ajzen I. The theory of planned behavior. Organizational behavior and human decision process. 1991;(50):179-221.

Hamilton K, Spinks T, White KM, Kavanagh DJ, Walsh AM. A psychosocial analysis of parents’ decisions for limiting their young child’s screen time: an examination of attitudes, social norms and roles, and control perceptions. Br J Health Psychol. 2016;21(2):285-301. https:// doi.org/10.1111/bjhp.12168.

Lin YM, Kuo SY, Chang YK, Lin PC, Lin YK, Lee PH, et al. Effects of parental education on screen time, sleep disturbances, and psychosocial adaptation among Asian preschoolers: a randomized controlled study. J Pediatr Nurs. 2021;56:e27-34. https://doi.org/10.1016/j. pedn.2020.07.003

Wu L, Sun S, He Y, Jiang B. The effect of interventions targeting screen time reduction: a systematic review and meta-analysis. Medicine (Baltimore). 2016;95(27): e4029. doi: 10.1097/MD.0000000000004029.

Chokprajakchad M, Phuphaibul R, Sieving ER, Phumonsakul S. Effectiveness of parent participation in a technology-based adolescent sexuality education program: a randomized control trial. Pacific Rim Int J Nurs Res [Internet]. 2020 Mar 14 [cited 2022 Feb 2]; 24(2):219-32. Available from https://he02.tcithaijo.org/index.php/PRIJNR/ article/view/190660

Bhusiri P, Phuphaibul R, Suwonnaroop N, Viwatwongkasem C. Effects of parenting skills training program for aggressive behavior reduction among school-aged children: a quasi-experimental study. Pacific Rim Int J Nurs Res [Internet]. 2018 Sep 28 [cited 2022 Feb 14];22(4):332-46. Available from https://he02.tcithaijo.org/index.php/ PRIJNR/article/view/82169

Hamilton K, Hatzis D, Kavanagh DJ, White KM. Exploring parents’ beliefs about their young child’s physical activity and screen time behaviours. J Child Fam Stud. 2015;24(9): 2638-52.

Solomon-Moore E, Sebire SJ, Macdonald-Wallis C, Thompson JL, Lawlor DA, Jago R. Exploring parents’ screen-viewing behaviours and sedentary time in association with their attitudes toward their young child’s screen-viewing. Prev Med Rep. 2017;7:198-205. http://doi.org/10. 1016/j.pmedr.2017.06.011

Yilmaz G, Demirli CN, Karacan CD. An intervention to preschool children for reducing screen time: a randomized controlled trial. Child Care Health Dev. 2015;41(3):443-9. https://doi.org/10.1111/cch.12133

Pempek TA, Lauricella AR. The effects of parent-child interaction and media use on cognitive development in infants, toddlers, and preschoolers. In: Blumberg FC, Brooks PJ, editors. Cognitive development in digital contexts. Elsevier; 2017. pp. 53-74. https://doi.org/10.1016/ B978-0-12-809481-5.00003-1

Detnakarintra K, Trairatvorakul P, Pruksananonda C, Chonchaiya W. Positive mother‐child interactions and parenting styles were associated with lower screen time in early childhood. Acta Paediatr. 2020;109(4):817-26.

Downing KL, Hnatiuk JA, Hinkley T, Salmon J, Hesketh KD. Interventions to reduce sedentary behaviour in 0-5-year-olds: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2018;52(5), 314-21. http://dx.doi.org/10.1136/bjsports-2016-096634

Downing KL, Salmon J, Hinkley T, Hnatiuk JA, Hesketh KD. A mobile technology intervention to reduce sedentary behaviour in 2-to 4- year-old children (Mini Movers): study protocol for a randomised controlled trial. Trials. 2017;18(1):97. https://doi.org/10.1186/s13063- 017-1841-7

Lewis L, Povey R, Rose S, Cowap L, Semper H, Carey A, et al. What behavior change techniques are associated with effective interventions to reduce screen time in 0–5-year-olds? a narrative systematic review. Prev Med Rep. 2021;(23): 101429. doi:10.1016/j.pmedr.2021.101429.

Downing KL, Salmon J, Hinkley T, Hnatiuk JA, Hesketh KD. Feasibility and efficacy of a parent-focused, text message-delivered intervention to reduce sedentary behavior in 2- to 4-Year-old children (mini movers): pilot randomized controlled trial. JMIR Mhealth Uhealth 2018;6(2):e39. https://doi: 10.2196/mhealth.8573

Hinkley T, Cliff D, Lum J, Hesketh K. Active minds happy kids: a stealth-based pilot intervention targeting preschoolers’ screen-time, outdoor play and social skills. J Sci Med Sport. 2017;20:e3-4. https://doi.org/10.1016/j.jsams. 2016.12.011

Birken CS, Maguire J, Mekky M, Manlhiot C, Beck CE, Degroot J, et al. Office-based randomized controlled trial to reduce screen time in preschool children. Pediatrics. 2012;130(6):1110-5. https://doi.org/10.1542/ peds.2011-3088

Rai J, Kuzik N, Carson V. Demographic, parental and home environment correlates of traditional and mobile screen time in preschool-aged children. Child Care Health Dev. 2022;48(4):544-51. doi: 10.1111/cch.12958

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Published

2023-03-27

How to Cite

1.
Boonmun W, Rutja Phuphaibul, Sirichai Hongsanguansri, Apawan Nookong, Natkamol Chansatitporn. A Program for Parents’ Screen Time Reduction for Preschool Children: A Quasi-experimental Study. PRIJNR [Internet]. 2023 Mar. 27 [cited 2024 Dec. 27];27(2):368-80. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/260440