JMIR Publications

ABSTRACT

Background:

Excessive screentime is associated with poor health and behavioral outcomes in children. However, research on screen time use has been hindered by methodological limitations including retrospective reports of ’usual’ screen time and lack of momentary etiologic processes occurring within each day. 

Objective:

The study is designed to assess the feasibility of a passive mobile sensing protocol to measure smartphone screen time and context. This paper describes the recruitment, data collection, and analytic protocols for the Tots & Tech Study.

Methods:

The Tots & Tech Study is a longitudinal, observational study of 100 dyads: caregivers and their preschool age children (3 to 5 years old). Both caregivers and children wear an Axivity AX3 accelerometer for 30 days to assess physical activity, sedentary behavior, and sleep. Caregivers complete Ecological Momentary Assessments (EMAs) for one week to measure child behavior problems, caregiver stress, and child screen time.

Results:

This study maintains rolling recruitment, with each dyad on their own assessment schedule, depending on time of enrollment. Enrollment is scheduled to take place between September 2020 and to continue through May 2022.

Conclusions:

The Tots & Tech Study attempts to overcome previous methodological limitations by using objective measures of screen time, physical activity, sedentary behavior, and sleep behaviors with contextual factors measured by EMA. Results will be used to evaluate the feasibility, acceptability, and validity of utilizing objective measures of mobile screen time and accelerometry in conjunction with EMA among caregiver-child dyads. Future observational and intervention studies will be able to utilize this study protocol in order to better measure screen time and its context. We will examine the within-dyad daily dynamics and between-dyad associations of parenting practices with child behavior problems as potential mechanisms impacting child health behaviors. Results will inform the processes that underly the association between screen time and physical (i.e. sleep & activity) and mental health (i.e. behavior problems).