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Original Investigation |

Early Childhood Electronic Media Use as a Predictor of Poorer Well-being:  A Prospective Cohort Study

Trina Hinkley, PhD1; Vera Verbestel, MSc2; Wolfgang Ahrens, PhD3; Lauren Lissner, PhD4; Dénes Molnár, PhD5; Luis A. Moreno, PhD6; Iris Pigeot, PhD7,8; Hermann Pohlabeln, PhD7; Lucia A. Reisch, PhD9; Paola Russo, BSc10; Toomas Veidebaum, PhD11; Michael Tornaritis, PhD12; Garrath Williams, PhD13; Stefaan De Henauw, PhD2,14; Ilse De Bourdeaudhuij, PhD2; for the IDEFICS Consortium
[+] Author Affiliations
1Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia
2Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
3Bremen Institute for Prevention Research and Social Medicine, University of Bremen, Bremen, Germany
4Department of Public Health and Community Medicine, University of Göteborg, Göteborg, Sweden
5Department of Paediatrics, University of Pécs, Pécs, Hungary
6Faculty of Science, University of Zaragoza, Zaragoza, Spain
7Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany
8Department of Mathematics/Computer Science, University of Bremen, Bremen, Germany
9Department of Intercultural Communication and Management–DEN, Consumer Sciences, Copenhagen Business School, Frederiksberg, Denmark
10Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
11National Institute for Health Development, Tervise Arengu Instituut, Tallinn, Estonia
12Research and Education Institute of Child Health, Strovolos, Cyprus
13Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, England
14Department of Public Health, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
JAMA Pediatr. 2014;168(5):485-492. doi:10.1001/jamapediatrics.2014.94.
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Importance  Identifying associations between preschool-aged children’s electronic media use and their later well-being is essential to supporting positive long-term outcomes.

Objective  To investigate possible dose-response associations of young children’s electronic media use with their later well-being.

Design, Setting, and Participants  The IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants) study is a prospective cohort study with an intervention component. Data were collected at baseline from September 1, 2007, through June 30, 2008, and at follow-up from September 1, 2009, through May 31, 2010, in 8 European countries participating in the IDEFICS study. This investigation is based on 3604 children aged 2 to 6 years who participated in the longitudinal component of the IDEFICS study only and not in the intervention.

Exposure  Early childhood electronic media use.

Main Outcomes and Measures  The following 6 indicators of well-being from 2 validated instruments were used as outcomes at follow-up: Peer problems and Emotional problems subscales from the Strengths and Difficulties Questionnaire and Emotional well-being, Self-esteem, Family functioning, and Social networks subscales from the KINDLR (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents–Revised Version). Each scale was dichotomized to identify those children at risk for poorer outcomes. Indicators of electronic media use (weekday and weekend television and electronic game [e-game]/computer use) from baseline were used as predictors.

Results  Associations varied between boys and girls; however, associations suggested that increased levels of electronic media use predicted poorer well-being outcomes. Television viewing on weekdays or weekends was more consistently associated with poorer outcomes than e-game/computer use. Across associations, the likelihood of adverse outcomes in children ranged from a 1.2- to 2.0-fold increase for emotional problems and poorer family functioning for each additional hour of television viewing or e-game/computer use depending on the outcome examined.

Conclusions and Relevance  Higher levels of early childhood electronic media use are associated with children being at risk for poorer outcomes with some indicators of well-being. Further research is required to identify potential mechanisms.

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