From: Screen-viewing among preschoolers in childcare: a systematic review
Authors | Country | Design | Sample | Study purpose | Method of assessing screen-viewing | Availability of screen-viewing activities | Rates of screen-viewing |
---|---|---|---|---|---|---|---|
▪ Bacigalupa (2005) [47] | ▪ United States | ▪ Mixed-methods | ▪ 1 home-based childcare facility | ▪ Three-fold: | ▪ Field notes (direct observation) | ▪ Each child permitted 18 minutes of video games/day: | |
▪ 6 preschoolers (mean age = ~5 years†∇; 50% male) | 1. Examine video game use by young children | - Children sat and watched the others play (6 children x 18mins = 108 mins/day or 1.8 hrs/day) | |||||
2. Explore the nature of children’s interactions during video game use | - Could “earn” extra minutes for good behavior | ||||||
3. Assess video game usage within the home childcare environment | |||||||
▪ Brown et al. (2009) [43] | ▪ United States | ▪ Cross-sectional | ▪ 24 center-based childcare facilities | ▪ Two-fold: | ▪ OSRAC-P (direct observation) | ▪ 0.15 hrs/day (or 8.92 mins/day) per child | |
▪ 476 preschoolers (mean age = 4.2 years [SD = 0.7]; 50% male) | 1. Describe the PA behaviors and the accompanying environmental/social events of preschoolers in childcare | - 2% was in light PA | |||||
1. Examine which conditions were predictors of MVPA and total PA | - 98% was sedentary | ||||||
▪ Christakis & Garrison (2009) [50] | ▪ United States | ▪ Cross-Sectional | ▪ 168 childcare facilities (84 home-based, 74 center-based) | ▪ Two-fold: | ▪ Telephone survey (proxy-report measure) | ▪ Mean (SD) television viewing across all participating facilities: | |
▪ Preschoolers’ age range = 3–5 years | 1. Investigate characteristics of programs that predict screen-viewing | - Home-based: 2.4 hrs/day (1.8) | |||||
2. Quantify television viewing in childcare settings | - Center-based: 0.4 hrs/day (0.9) | ||||||
▪ Mean (SD) television viewing across facilities that reported any screen-use in care: | |||||||
- Home-based: 3.4 hrs/day (2.8) | |||||||
- Center-based: 1.2 hrs/day (1.3) | |||||||
▪ Preschoolers in home-based childcare engaged in significantly more television than those in center-based care (p < .001) | |||||||
▪ > 90% of childcare facilities reported television being for educational or educational and entertainment purposes | |||||||
▪ Christakis et al. (2006) [11] | ▪ United States | ▪ Cross-sectional | ▪ 2,672 childcare facilities (583 home-based; 2,089 center-based) | ▪ Two-fold: | ▪ Survey (proxy-report measure) | ▪ Mean hours of daily television viewing: | |
▪ Preschoolers’ age range = 3–5 years | 1. Describe the amount and frequency of television viewing among preschoolers in childcare | - Home-based: 1.39 hrs/day∇ | |||||
2. Explore predictors of television viewing in the childcare setting | - Center-based: 0.36 hrs/day∇ | ||||||
▪ Preschoolers in home-based childcare watched ~4x more television than those in center-based care | |||||||
▪ Dowda et al. (2004) [51] | ▪ United States | ▪ Cross-sectional | ▪ 9 center-based childcare facilities: | ▪ Determine if levels of MVPA among preschoolers varied with differences in policies/practices, and overall quality of childcare facilities | ▪ ECERS-R (direct observation) | ▪ 3 PAP centers, < 45 mins/day (or < 0.75 hrs/day): | |
- 3 PAP centers (83 children) | - 5.7% (SD = 1.6) was in MVPA | ||||||
- 6 NPAP centers (183 children) | - 57.5% (SD = 4.8) was sedentary | ||||||
▪ 266 preschoolers (mean age = 4 years∇; 47% males) | ▪ 6 NPAP centers, ≥ 45 mins/day (or ≥ 0.75 hrs/day): | ||||||
- 7.1% (SD = 1.1) was in MVPA | |||||||
- 56.7% (SD = 3.4) was sedentary | |||||||
▪ Finch et al. (2012) [52] | ▪ Australia | ▪ Quasi-experimental (intervention, 2-arm) | ▪ 484 center-based childcare facilities (275 intervention, 209 control) | ▪ Describe impact of an intervention tasked with increasing the adoption of PA-promoting policies/practices in center-based childcare | ▪ Telephone survey (proxy-report measure) | ▪ Prevalence of PA policies/practices in centers (at baseline): | |
▪ Preschoolers’ age range = 3–5 years | - 45-60%: policy that limits screen time | ||||||
- 17-23%: children are allowed to watch screens less than once per week | |||||||
▪ Finch et al. (2014) [53] | ▪ Australia | ▪ Cluster randomized control trial | ▪ 20 center-based childcare facilities (10 in intervention, 10 in control) | ▪ Evaluate the impact of a cluster randomized trial on the PA levels of 3–5 year old children attending center-based childcare | ▪ EPAO (direct observation) | ▪ Mean (SD) television viewing = 6.90 (21.82) mins/day | |
▪ 457 preschoolers; age range = 3–5 years; ~55% male) | |||||||
▪ Gunter et al. (2012) [54] | ▪ United States | ▪ Cross-sectional | ▪ 53 home-based childcare facilities | ▪ Asses the current status of PA- and nutrition-related policies/practices in home-based childcare facilities to help inform the Journey to a Healthy Child Care Home childhood obesity intervention | ▪ NAP SACC (proxy-report measure) | ▪ Prevalence of screen-viewing policies/practices in centers: | |
▪ 205 preschoolers (age range = 2–5 years) | - 60.4%: television is turned on every day for at least part of the day | ||||||
- 58.5%: children are allowed to watch television/videos or play video games at least once a day | |||||||
- 20.8%: children are allowed to use a computer for educational purposes or games at least once a day | |||||||
▪ McWilliams et al. (2009) [55] | ▪ United States | ▪ Cross-sectional | ▪ 96 center-based childcare facilities (only 42 with television data) | ▪ Demonstrate how current practices of a large sample of childcare centers compare to best-practice PA guidelines | ▪ EPAO (proxy-report measure) | ▪ Number of centers engaging in television viewing time (with television present in classroom): | |
▪ 66 children/center (median enrollment; where ~50% were 3–5 years) | - 17: ≤ 30 mins/day (or ≤ 0.50 hrs/day) | ||||||
- 16: ≥ 31 ≤ 60 mins/day (or ≥ 0.50 ≤ 1 hr/day) | |||||||
- 9: > 60 mins/day (or > 1 hr/day) | |||||||
▪ Natale et al. (2013) [56] | ▪ United States | ▪ Cross-sectional | ▪ 1,140 childcare facilities (842 center-based, 298 home-based) | ▪ Explore and differentiate between the PA and nutrition patterns of center- and home-based childcare facilities | ▪ Physical Activity Frequency Questionnaire (proxy-report measure) | ▪ Television viewing limited to ≤ 60 mins/day (or ≤ 1 hr/day; once a week) | |
▪ Preschoolers’ age range = 3–5 years (~50% male) | ▪ Center-based: 474 | ||||||
▪ Home-based: 113* | |||||||
▪ Computer use limited to ≤ 60 mins/day (or ≤ 1 hr/day; once a week) | |||||||
▪ Center-based:410 | |||||||
▪ Home-based: 186* | |||||||
▪ Sisson et al. (2012) [57] | ▪ United States | ▪ Cross-sectional | ▪ 314 center-based childcare facilities | ▪ To determine the obesogenic practices of full-day childcare centers | ▪ NAP SACC (proxy-report measure) | ▪ Prevalence of screen-viewing practices in centers: | |
▪ Preschoolers’ age range = 2–5 years | - 57.4%: television is rarely/never used | ||||||
▪ Tandon et al. (2011) [58] | ▪ United States | ▪ Cross-sectional | ▪ 6,050 preschoolers (1,900 in home-based childcare; 4,150 in center-based childcare; mean age = 4.37 years [SE = 0.01]; 51% male) | ▪ Three-fold: | ▪ Telephone survey (proxy-report measure) | ▪ Mean television viewing: | |
1. Assess preschoolers cumulative daily screen time | - Home-based: 1.8 hrs/day∇ | ||||||
2. Measure the contributions of the home and childcare setting to this total | - Center-based: 0.1 hrs/day∇ | ||||||
3. Characterize children most at risk for excessive screen time | ▪ Preschoolers in center-based childcare watched significantly less television in comparison to those attending home-based care (p < .001) | ||||||
▪ Taverno Ross et al. (2013) [48] | ▪ United States | ▪ Multi-component intervention | ▪ 16 center-based childcare facilities | ▪ Explore the separate influences of “childcare television” vs. “home television” vs. “cumulative television” on preschoolers’ PA and weight | ▪ 3-item survey examining the rules, use, and availability of television in childcare (proxy-report measure) | ▪ Childcare environment was highly conducive to television viewing | |
▪ 339 preschoolers (mean age = 4.5 years [SD = 0.3]; 52.2% males) | ▪ Mean (SD) of summed scores (i.e., TV availability, rules, use) at baseline = 4.1 (1.8) out of 11 (where a lower score indicates an screen-viewing supportive environment) | ||||||
▪ Trost et al. (2009) [59] | ▪ United States | ▪ Cross-sectional | ▪ 297 home-based childcare facilities | ▪ Describe nutrition- and PA-related policies/practice in a representative sample of home-based childcare facilities | ▪ NAP SACC (proxy-report measure) | ▪ Prevalence of screen-viewing policies/practices in centers: | |
▪ Preschoolers’ age range = 2–5 years | - 64.6%: television is turned on every day for at least part of the day | ||||||
- 55.1%: children are allowed to watch television/videos or play video games at least once a day | |||||||
- 33.2%: children are allowed to use a computer for educational purposes or games at least once a day | |||||||
▪ Trost et al. (2011) [60] | ▪ United States | ▪ Quasi-experimental (intervention) | ▪ 236 home-based childcare facilities | ▪ Determine the impact of a community-based train-the-trainer intervention on the nutrition- and PA-related policies/practice of home-based childcare facilities | ▪ NAP SACC (proxy-report measure) | ▪ Mean (SD) score for television use and viewing: 2.9 (0.8) [out of 4, where a score of 4 = best practice of never/rarely watching screens] | |
▪ Preschoolers’ age range = 2–5 years | |||||||
▪ Wolfenden et al. (2010) [61] | ▪ Australia | ▪ Cross-sectional | ▪ 261 center-based childcare facilities (112 pre-schools, 149 long-day care settings) | ▪ Two-fold: | ▪ Telephone survey (proxy-report measure) | ▪ 25-30% of centers (preschools and long-day care settings, respectively) provided daily opportunities to engage in screen activities | |
▪ 27 children/pre-school (mean enrolment; age range = 3–5 years) | 1. Describe PA-related policies/practices of childcare programs | ▪ Policy supports limiting screen recreation | |||||
▪ 39 children/long-day care setting (mean enrollment; age range = 6 weeks-under 6 years) | 2. Ascertain whether characteristics like socio-economic status, remoteness, or size predict these policies and/or practices | - Preschools = 35 | |||||
- Long-day care settings = 69 | |||||||
▪ Zevenbergen & Logan (2008) [62] | ▪ Australia | ▪ Cross-sectional | ▪ 25 childcare facilities | ▪ Determine the amount of access young children had to computers at home and in the childcare setting | ▪ Survey (proxy-report measure) | ▪ Mean frequency of access to computers in childcare = 1.04±∇ (out of 3, where a score of 3 = frequent) | |
▪ 150 preschoolers (age range = 4–5 years) | ▪ Majority of activities undertaken while using the computer were educational games, followed by non-educational games |