JMIR Publications

ABSTRACT

Background:

Parents, as the most proximal influence on young children, play an important role in shaping toddler behaviors. Yet, evidence on how parents shape toddler screen use is limited. Little is also known about the relationship of toddler screen use with body mass index (BMI). Given existing disparities in screen use and early childhood obesity, a focus on Mexican American families with toddlers is warranted.

Objective:

To evaluate the independent contributions of both maternal screen use and screen-related parenting practices with toddler screen use duration, for both TV viewing and mobile device use, and examine the relationship between toddler screen use duration and BMI.

Methods:

This cross-sectional study enrolled 384 Mexican American mother-toddler dyads recruited from safety net clinics. Enrolled mothers completed 7-day screen use diaries, surveys on screen-related parenting practice, and toddler anthropometrics were obtained. Negative binomial regression models estimated the relationships between screen-related parenting practices and mother screen use (predictors) with child duration of daily TV use and mobile device use (outcomes). Spearman correlations were calculated to estimate the relationship between toddler screen use duration and age- and sex-specific BMI-z scores.

Results:

Maternal duration of daily TV and mobile device use were associated with toddler duration of daily TV (adjusted rate ratios (aRR): 1.27-1.28; Ps<.001) and mobile device use (aRR: 1.17-1.18; Ps<.001) respectively, even after adjusting for maternal screen-related parenting practices. Specific parenting practices, including restriction of TV time (aRR=0.86, P=.01), restriction of mobile device time (aRR=0.80, P=.02), use of TV (aRR=1.27, P=.003), and mobile devices (aRR=1.78, P<.001) for child behavior regulation, and coviewing of mobile devices (aRR=1.51, P<.001), were associated with toddler duration of daily screen use, adjusted for maternal duration of daily screen use. Neither toddler duration of daily TV viewing nor daily mobile device use were correlated with toddler BMI-z scores.

Conclusions:

oth the duration of maternal screen use and screen-related parenting practices, for both TV and mobile devices, should be considered when promoting healthy screen use in toddlers in Mexican American families. Interventionists should consider the family ecology when designing interventions promoting healthy screen use in early childhood.