Currently submitted to: JMIR Pediatrics and Parenting
Date Submitted: Feb 28, 2026
Open Peer Review Period: Mar 2, 2026 - Apr 27, 2026
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Parent Perspectives on Screen Time and the Healthy Media Use Contract: A Qualitative Study
ABSTRACT
Background:
Despite the many negative health outcomes associated with unhealthy screen media use, patient counseling by pediatricians in the primary care setting remains a challenge. The American Academy of Pediatrics (AAP) developed the Family Media Plan, but its online format may not lend itself to use in the time-constrained clinical setting.
Objective:
This exploratory study describes parent perceptions toward screen media use and family-perceived utility of the Healthy Media Use Contract (HMUC), a simplified, 1-page print version of the AAP HealthyChildren.org Family Media Plan for use in the clinical setting.
Methods:
A qualitative phenomenological approach was used to explore family experience with the HMUC. Families of children ages 6-13 years scheduled for primary care appointments were identified and consented in clinic prior to their appointment. During their appointment, their physician provided the family with the HMUC alongside standard screen media use counseling. Families were encouraged to post the HMUC in a common area within the home (e.g., on the refrigerator). Approximately one month after their clinic appointment, participating families completed a semi-structured interview via phone or Zoom to describe their experience using the HMUC. Families were provided a $25 gift card as a thank-you for participating. Interviews were transcribed and analyzed for themes.
Results:
Eight semi-structured, qualitative interviews were completed (English: 6, Spanish: 2). Saturation was assessed through ongoing, concurrent data analysis, and the point at which no new codes or themes emerged was confirmed through consensus among all team members. Qualitative coding and thematic analysis revealed the following screentime-related themes: 1) Parents identify both the benefits and drawbacks of screen media use, a sentiment we have labeled “nuanced neutrality,” 2) A lack of viable alternative activities is a major driver of screen media use, and 3) a lack of predictable family routines was a major factor for families who did not use the contract. Additionally, the following HMUC-related themes emerged: 1) The HMUC increased awareness of family screen time, 2) Delivery of screen media guidance was viewed favorably by families, 3) Rewards were valuable in prompting behavior change, and 4) The use of a contract promoted commitment.
Conclusions:
This study illustrates the nuanced perspectives contemporary parents hold regarding their children’s screen media use. Further, it delineates the specific attributes of the HMUC and its implementation that are perceived by families as effective.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.