Family Caregiver Factors Predicting Excessive Smartphone Use of Thai Preschool Children: A Cross-Sectional Study
DOI:
https://doi.org/10.60099/prijnr.2026.276328Keywords:
Excessive smartphone use, Family caregivers, Adolescent mothers; Predicting factors; Postpartum depression; Thailand, Preschool childrenAbstract
Smartphone overuse among preschoolers is an increasing concern globally. Although several studies have explored these contributing factors, the evidence specific to family-related factors influencing excessive smartphone use during preschool age remains limited. These family-related factors included parents’ screen time, attitudes, mediation approach, education, employment status, family income, and household chaos. This cross-sectional study aimed to examine family-related factors that predict excessive smartphone use among preschool children. Multistage random sampling was employed to recruit 647 family caregivers. The instruments used for data collection included the Demographic Data Form, Screen Time Questionnaire, the Mediation Scale, Attitudes toward Smartphone Use Questionnaire, Home Chaos Environment Questionnaire, and the Children’s Smartphone Usage Habits Questionnaire. All data were collected by telephone or LINE calling interview. Descriptive statistics, correlation, and logistic regression were applied to analyze the data.
The findings indicated that caregiver educational level, caregivers’ weekday and weekend screen time, and caregivers’ affective attitudes were significant predictors of the excessive use habit, with a 95% CI. The model’s predictive accuracy was 56.10%. Nurses can use this finding to design intervention focus on caregiver support strategies to promote healthy smartphone use habits among preschoolers with further testing is needed.
References
Qian H, Wang C, Li H. Parental risk factors and moderators of prolonged digital use in preschoolers: A meta-analysis. Educ. Inf. Technol. 2024;29:17601-17619. https://doi.org/10.1007/s10639-024-12558-6.
American Academy of Pediatrics. Media and young minds. Pediatrics. 2016;138(5):e20162591. https://doi.org/10.1542/peds.2016-2591.
World Health Organization. Guidelines on physical activity, sedentary behavior, and sleep for children under 5 years of age [Internet]. 2019 [cited 2024 Dec 25]. Available from: https://apps.who.int/iris/bitstream/handle/10665/311664/9789241550536-eng.pdf?sequence=1&isAllowed=y
Kwon S, Armstrong B, Wetoska N, Capan S. Screen time, sociodemographic factors, and psychological well-being among young children. JAMA Network Open Pediatrics. 2024;7:e2354488. doi:10.1001/jamanetworkopen.2023.54488
Hadi AA, Akmal N, Aidid ME. Screen media dependency and its associated factors among preschool children in Kuala Lumpur. Mal J Med Health Sci. 2023;19(3):204-214. doi:10.47836/mjmhs19.3.26
Bureau of National Economic and Social Development. Children and youth situation report [Internet]. 2018 [cited 2024 Dec 25]. Available from: https://www.dcy.go.th/webnew/index.php.(in Thai)
Ashaari HS, Mayilvahanam S, Ahmad D, Saat R, Rameli EF. Screen time and health impact among preschool children. IJ-ARBSS. 2024;14(5):1332-1340. http://dx.doi.org/10.6007/IJARBSS/v14-i5/21550.
Xiao Y, Emmers D, Li S, Zhang H, Rule A, Rozelle S. Screen exposure and early childhood development in resource-limited regions: findings from a population-based survey study. J Med Internet Res. 2025;27:e68009). doi: 10.2196/68009.
Li J. The association between smartphone use and myopia progression in children: a prospective cohort study. BMC Pediatr. 2025;25:378. https://doi.org/10.1186/s12887-025-05715-4.
Xu Y, Qiao L. Digital screen exposure and emotional symptoms in preschool children: mediation by parent–child relationship and moderation by peer relationships. Front Psychol. 2025;16:1584919. doi:10.3389/fpsyg.2025.1584919.
Hutton JS, Dudley J, Horowitz-Kraus T, DeWitt T, Holland SK. Associations between screen-based media use and brain white matter integrity in preschool-aged children. JAMA Pediatr. 2020;174(1):e193869. doi:10.1001/jamapediatrics.2019.3869.
Zhou Y, Jiang X, Wang R, Guo B, Cai J, Gu Y, Pei J. The relationship between screen time and attention deficit/hyperactivity disorder in Chinese preschool children under the multi child policy: a cross-sectional survey. BMC Pediatr. 2023;23:361. https://doi.org/10.1186/s12887-023-04130-x.
Sampaio ML, Lourdes M, Santana M, María Bitat del Pilar Etopa M. Use of mobile devices and psychosocial difficulties in children under 12 years of age: A systematic review and meta-analysis. Curr Psychol. 2025;44:15143–15156. https://doi.org/10.1007/s12144-025-08198-9 0.
Beatty C, Egan SM. Screen time in early childhood: a review of prevalence, evidence and guidelines. OMEP Ireland. 2020;13(1):17-31. https://omepireland.ie/wp-content/uploads/2020/08/AN-LEANBH-OG-VOL13.pdf#page=17
O’Neill B. Ecological perspectives and children’s use of the Internet: exploring micro to macro level analysis. Eesti Haridusteaduste Ajakiri Estonian J Educ. 2015;3(2):32–53. doi: 10.12697/eha.2015.3.2.02b.
Scott F, Marsh J, Murris K, Ng'ambi D, Thomsen BS, Bannister C, et.al. An ecological perspective on children’s play with digital technologies in South Africa and the United Kingdom. Int J Play. 2023;12(3):349–74. doi: 10.1080/21594937.2023.2235466.
Domoff SE, Borgen AL, Radesky JS. Interactional theory of childhood problematic media use. Hum Behav Emerg Technol. 2020;2(4):343-53. doi: 10.1002/hbe2.217.
Lauricella AR, Wartella E, Rideout VJ. Young children's screen time: the complex role of parent and child factors. J Appl Dev Psychol. 2015;36:11-17. doi: 10.1016/j.appdev.2014.12.001.
Lauricella AR, Cingel DP, Beaudoin-Ryan L, Robb MB, Saphir M, Wartella EA. The common sense census: plugged-in parents of tweens and teens [Internet]. [cited 2024 Dec 25]. Available from: https://www.commonsensemedia.org/sites/default/files/research/report/common-sense-parent-census_whitepaper_new-for-web.pdf
Haddock G, Maio GR. Attitudes: content, structure and functions. 2008. In Maio GR, Verplanken B, Haddock G (editors). The psychology of attitudes and attitude change; SAGE Publications Ltd; 2008, p. 112-33.
Chaudron S, Di GR, Gemo M. Young children (0-8) and digital technology: a qualitative exploratory study across seven countries: Joint Research Centre, European Commission [internet]. 2015 [cited 2024 Dec 25]. Available from: https://shorturl.at/UQW8a
Nimrod G, Elias N, Lemish D. Measuring mediation of children’s media use. Int J Commun Res. 2019;13:342–58. https://ijoc.org/index.php/ijoc/article/view/10237
Wu CST, Fowler C, Lam WYY, Wong HT, Wong CHM, Loke AY. Parenting approaches and digital technology use of preschool age children in a Chinese community. Ital J Pediatr. 2014;40(1):1-8. doi: 10.1186/1824-7288-40-44.
Van der Geest KE, Mérelle SYM, Rodenburg G, Van de Mheen D, Renders CM. Cross-sectional associations between maternal parenting styles, physical activity and screen sedentary time in children. BMC Public Health. 2017;17(1):1-10. doi: 10.1186/s12889-017-4784-8.
Carson V, Kuzik N. Demographic correlates of screen time and objectively measured sedentary time and physical activity among toddlers: a cross-sectional study. BMC Public Health. 2017;17(1):1-11. doi: 10.1186/s12889-017-4125-y.
Määttä S, Kaukonen R, Vepsäläinen H, Lehto E, Ylönen A, Ray C, et.al. The mediating role of the home environment in relation to parental educational level and preschool children’s screen time: a cross-sectional study. BMC Public Health. 2017; 17(1):688. doi: 10.1186/s12889-017-4694-9.
McCloskey M, Krull E, Radecki L. Socioeconomic status and child media use: a mixed methods study. J Pediatr Health Care. 2018;32(2):154-61. doi: 10.1016/j.jneb.2017.03.006.
Lee ST, Wong JE, Ong WW, Ismail MN, Deurenberg P, Poh BK. Physical activity pattern of Malaysian preschoolers: environment, barriers, and motivators for active play. Asia Pac J Public Health. 2016;28(Suppl 5):21S-34S. doi: 10.1177/1010539516638155.
Emond JA, Tantum LK, Gilbert-Diamond D, Kim SJ, Lansigan RK, Neelon SB. Household chaos and screen media use among preschool-aged children: a cross-sectional study. BMC Public Health. 2018;18:1-8. doi: 10.1186/s12889-018-6113-2.
Evans GW, Gonnella C, Marcynyszyn LA, Gentile L, Salpekar N. The role of chaos in poverty and children's socioemotional adjustment. Psychol Sci. 2005;16(7):560–5. doi: 10.1111/j.0956-7976.2005.01575.x.
Eales L, Gillespie S, Alstat RA, Ferguson GM, Carlson SM. Children’s screen and problematic media use in the United States before and during the COVID‐19 pandemic. Child Dev. 2021;92(5):e866-e882. doi: 10.1111/cdev.13652.
Cohen J. Statistical power analysis for the behavioral sciences. New York, NY: Routledge Academic [internet]; 1988 [cited 2025 Aug 27]. Available from: https://utstat.utoronto.ca/brunner/oldclass/378f16/readings/CohenPower.pdf
Selya AS, Rose JS, Dierker LC, Hedeker D, Mermelstein RJ. A practical guide to calculating Cohen’s f², a measure of local effect size, from PROC MIXED. Front Psychol. 2012;3:111. doi: 10.3389/fpsyg.2012.00111.
World Health Organization. WHODAS 2.0 translation package: translation and linguistic evaluation protocol and supporting material [internet]. 2018 [cited 2024 Dec 25]. Available from: https://terrance.who.int/mediacentre/data/WHODAS/Guidelines/WHODAS%202.0%20Translation%20guidelines.pdf
Klakk H, Wester CT, Olesen LG, Rasmussen MG, Kristensen PL, Pedersen J, et.al. The development of a questionnaire to assess leisure time screen-based media use and its proximal correlates in children (SCREENS-Q). BMC Public Health. 2020;20:1–12. doi: 10.1186/s12889-020-08810-6.
Sigmund E, Badura P, Vokacova J, Sigmundová D. Parent-child relationship of pedometer-assessed physical activity and proxy-reported screen time in Czech families with preschoolers. Int J Environ Res Public Health. 2016;13(7):740. doi: 10.3390/ijerph13070740.
Boonmun W, Phuphaibul R, Hongsanguansri S, Nookong A, Chansatitporn N. A program for parents’ screen time reduction for preschool children: a quasi-experimental study. Pacific Rim Int J Nurs Res. 2023;27(2): 368-380. https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/260440
Geurts SM, Koning IM, Vossen H, Van den Eijnden RJ. A qualitative study on children’s digital media use and parents’ self-interest. J Child Fam Stud. 2022; 31(7):2015–2026. doi: 10.1007/s10826-021-02074-3.
Gözüm S, Kandır A. parental mediation strategies and digital competence: a correlational study. Int J Early Child Educ. 2021;27(2):145–60. doi: 10.1007/s10639-020-10382-2.
Abdullah NN, Rahim HF, Ariffin NA, Kamaruddin MA, Baharom N, Rahman RA, et al. The influence of sociodemographic factors on mobile device use among young children in Putrajaya, Malaysia. Children (Basel). 2022;9(2):228. doi:10.3390/children9020228.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2026 Pacific Rim International Journal of Nursing Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.
.png)
