Skip to main content

Table 2 Characteristics of included studies which examined rates of screen-viewing and/or screen-viewing opportunities in childcare

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  
  1. Note: † = personal communication with author (majority of participants were 5 years old with none over 6 years); SE = standard error; SD = standard deviation; = value not reported (i.e., study authors did not provide SD or presented data was used to extrapolate a value by review author, and as such, no SD available); ± = this score may have represented an anomaly (disproportionally high score attributed to one center with a high response rate – when removed, mean frequency = 0.30); * = significant difference; OSRAC-P = Observational System for Recording Physical Activity in Children-Preschool Version; ECERS-P = Early Childhood Environment Rating Scale-Revised Edition; EPAO = Environmental and Policy Assessment and Observation; NAP SACC = Nutrition and Physical Activity Self-Assessment for Child Care; PA = physical activity; MVPA = moderate-to-vigorous physical activity; PAP = physical activity promoting; NPAP = non-physical activity promoting.