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Paediatr Child Health. Nov 2006; 11(9): 595–599.
PMCID: PMC2528654

Language: English | French

Television viewing, computer use and total screen time in Canadian youth

Amy E Mark, MSc,1 William F Boyce, PhD,2,4 and Ian Janssen, PhD1,2

Abstract

BACKGROUND

Research has linked excessive television viewing and computer use in children and adolescents to a variety of health and social problems. Current recommendations are that screen time in children and adolescents should be limited to no more than 2 h per day.

OBJECTIVE

To determine the percentage of Canadian youth meeting the screen time guideline recommendations.

METHODS

The representative study sample consisted of 6942 Canadian youth in grades 6 to 10 who participated in the 2001/2002 World Health Organization Health Behaviour in School-Aged Children survey.

RESULTS

Only 41% of girls and 34% of boys in grades 6 to 10 watched 2 h or less of television per day. Once the time of leisure computer use was included and total daily screen time was examined, only 18% of girls and 14% of boys met the guidelines. The prevalence of those meeting the screen time guidelines was higher in girls than boys.

CONCLUSION

Fewer than 20% of Canadian youth in grades 6 to 10 met the total screen time guidelines, suggesting that increased public health interventions are needed to reduce the number of leisure time hours that Canadian youth spend watching television and using the computer.

Keywords: Canadian youth, Computer use, Screen time, Television viewing

Résumé

HISTORIQUE

Les recherches relient le temps excessif que passent les enfants et les adolescents à écouter la télévision et à utiliser l’ordinateur à divers troubles de santé et troubles sociaux. D’après les recommandations actuelles, le temps d’écran des enfants et des adolescents devrait se limiter à un maximum de deux heures par jour.

OBJECTIF

Déterminer le pourcentage de jeunes canadiens qui respectent les lignes directrices sur le temps d’écran.

MÉTHODOLOGIE

L’échantillon représentatif à l’étude se composait de 6 942 jeunes canadiens de la 6e à la 10e année qui avaient participé à l’Enquête 2001–2002 sur les comportements liés à la santé des enfants d’âge scolaire de l’Organisation mondiale de la santé.

RÉSULTATS

Seulement 41 % des filles et 34 % des garçons de la 6e à la 10e année regardaient la télévision deux heures ou moins par jour. Lorsque le temps d’utilisation de l’ordinateur pour les loisirs était ajouté au temps d’écran total quotidien, seulement 18 % des filles et 14 % des garçons respectaient les lignes directrices. La prévalence du respect de ces lignes directrices était plus élevée chez les filles que chez les garçons.

CONCLUSION

Moins de 20 % des jeunes canadiens de la 6e à la 10e année respectent les lignes directrices sur le temps d’écran total, ce qui laisse supposer l’importance d’augmenter les interventions de santé publique afin de réduire le nombre d’heures de loisirs que passent les jeunes canadiens à regarder la télévision et à utiliser l’ordinateur.

In the mid 1980s, researchers identified television viewing as a correlate of childhood obesity (1), a finding that has been confirmed by numerous other investigators (25). There is also substantive evidence that television viewing in children and adolescents is linked to numerous other health and social problems, including violence and aggressive behaviour, physical inactivity, initiation of early sexual behaviours, body self-image issues, and substance use and abuse (6). The excessive use of computers, including video games, appears to be associated with many of the same problems as watching television (6).

In 2001, the American Academy of Pediatrics released guidelines recommending that screen time (television and computer) in children and adolescents be limited to no more than 2 h per day (7). This recommendation was followed in 2002 by a statement on active healthy living from the Canadian Paediatric Society (CPS) indicating that most young people need to reduce their sedentary activities by 30 min per day, followed by a further reduction of 5 min per day each month until sedentary behaviours amount to no more than 90 min per day (8). A further statement by the CPS in 2003 recommended limiting television to no more than 2 h per day in school-aged youth (9). As evidence of the high volume of television watching in young people, findings from a representative sample of eight- to 16-year-old Americans indicate that 48% of boys and 38% of girls watch 2 h or more of television per day (3). These figures do not include computer and video game use. A study of children in California found that total screen time averaged 6.5 h per day (10).

At present, there is an absence of information on total screen time in Canadian youth, and subsequently, it is unknown what proportion of the population conforms to the guideline recommendation of 2 h or less of screen time per day. The purpose of the present study was to describe television, computer and total screen time in a representative sample of Canadian youth.

METHODS

Study population

Study results are based on the Canadian records from the 2001/2002 World Health Organization Health Behaviour in School-Aged Children Survey (HBSC). The authors of the present study are part of the Canadian HBSC investigative team, and WB is the Principal Investigator. The HBSC is a cross-sectional survey from 35 countries (11). The survey consisted of a classroom-based questionnaire. The Canadian data were collected in the first six months of 2002. The sample was designed according to the international HBSC protocol, in that a cluster design was used; the school class was the basic cluster, the distribution of the students reflected the distribution of Canadians in grades 6 to 10 (reflecting a 10- to 16-year-old age range), and the sample was self weighting (11). Samples were selected to represent distributions of schools by size, location, language and religion. The majority of the students (74.2%) selected for the study completed the questionnaire, and their demographic profile was representative of Canadians in the same age range. The sample included 7266 students; analysis was limited to those students who completed the survey questions related to television and computer use, resulting in a sample size of 6942.

The Canadian HBSC was approved by the Queen’s University General Research Ethics Board. Consent was obtained from the participating school boards, individual schools, parents and students. Student participation was voluntary.

Measurement of screen time

The amount of time spent watching television and using the computer were determined using the following questions: “About how many hours a day do you usually watch television (including videos) in your free time?” and “About how many hours a day do you usually use a computer (for playing games, emailing, chatting or surfing on the internet) in your free time?”. For each question, the response options were ‘none at all’, ‘about half an hour a day’, ‘about 1 hour a day’, ‘about 2 hours a day’, ‘about 3 hours a day’, ‘about 4 hours a day’, ‘about 5 hours a day’, ‘about 6 hours a day’ and ‘about 7 or more hours a day’. Questions were asked for both weekday and weekend use, and a weighted mean was calculated to determine the average amount of free time per day spent watching television and using the computer. Total screen time was calculated as the sum of television and computer hours. For television, computer and total screen time, subjects were categorized into those who did and did not meet the American Academy of Pediatrics (7) and CPS (9) guideline recommendation of 2 h or less per day.

Statistical analysis

Results were grouped by sex and age (grades 6 to 8 and grades 9 to 10). Descriptive statistics were used to describe the distribution of the three screen time variables and to estimate the prevalence of those who engaged in 2 h or less of screen time per day. χ2 tests were used to compare prevalences across sex and age groups. Statistical analyses were performed using SAS (SAS Institute, USA).

RESULTS

The study sample included 2410 girls and 2213 boys in grades 6 to 8, and 1319 girls and 1000 boys in grades 9 to 10. Percentile distributions for the various screen time measures are listed in Table 1. The 50th percentile for the various sex and age groups ranged from 2.29 h to 2.71 h per day for television viewing, 1.00 h to 1.57 h per day for computer use, and 3.71 h to 4.71 h per day for total screen time. Figure 1 illustrates the percentage of Canadian youth who engaged in 2 h per day or less (ie, those meeting the guidelines) of television viewing, computer use and total screen time. The prevalence of those meeting the guidelines varied by sex and grade, with prevalences being higher in girls than boys and higher in grade 6 to 8 students than in grade 9 to 10 students. Regardless of age group, the prevalence of girls (41%) who watched 2 h or less of television per day was higher than in boys (34%). For leisure time computer use (not including homework), 72% of girls and 65% of boys used the computer for 2 h or less per day. For total screen time (television and computer), only 18% of girls and 14% of boys met the guideline recommendations.

Figure 1
Prevalence of students meeting the screen time guideline of 2 h a day or less of entertainment media time for television time (A), computer time (B) and total screen time (C)
TABLE 1
Distribution of screen time variables according to sex and grade

DISCUSSION

Only 41% of girls and 34% of boys in grades 6 to 10 watched 2 h or less of television per day. Once leisure time computer use was included and total daily screen time was examined, only 18% of girls and 14% of boys met the recommendations of 2 h or less of entertainment media time per day. Fewer boys and fewer older youth conformed to the screen time guidelines.

Data from a nationally representative sample of 14- to 18-year-old American children conducted in 1999 (12) indicated that 37% of girls and 34% of boys watch less than 2 h of television per day. These values are quite comparable with those reported in the present study on Canadian youth. In a different representative survey of eight- to 18-year-old American children conducted in 1998/1999, it was reported that boys and girls averaged 5.8 h and 4.6 h of daily screen time, respectively (10). Results from the current study indicate that the average screen time, while comparable, is slightly lower in 10- to 16-year-old Canadian males (average 4.8 h/day) and females (average 4.1 h/day).

Cross-sectional studies indicate that children and adolescents who watch more than 2 h to 3 h of television per day are more likely to be overweight and obese, compared with their peers who watch less than these amounts (5,13). Understandably, youth who watch more television are less physically active (1,12,1416). Furthermore, time spent watching television is positively correlated with snacking (especially calorically dense foods) (17,18). The negative consequences of television and computer use are by no means limited to obesity. Spending more time watching television and playing video games increases exposure to violence, sexual content, negative body images, and irresponsible tobacco and alcohol use (6). For instance, during the first hour of primetime television, three out of every four programs contain sexual messages (as many as eight sexual incidences per hour), with little discussion relating to the risks and consequences of these behaviours (6). As for leisure time computer use, the most common video games are combat-related, and it is widely speculated that playing these types of games may influence real-life violence (10). Thus, it is quite concerning that fewer than 20% of Canadian youth in grades 6 to 10 meet current entertainment media time guidelines. With that in mind, to our knowledge, no studies have examined whether total screen time is related to risk behaviours and poor health outcomes, and in particular, whether total screen time is a better predictor of these outcomes than television or computer time alone. Furthermore, because most of the current evidence is based on results from cross-sectional studies, longitudinal studies are needed to confirm the evidence.

Three randomized trials have addressed the issue of reducing television viewing in youth. The first study (19) was a school-based intervention in third and fourth graders that consisted of 18 lessons aimed at reducing television and video game use, followed by a challenge to limit use to 7 h per week. Following the intervention, total screen time in the students attending the intervention schools was almost one-half that of the students attending the control schools (8.8 h/week versus 14.5 h/week) (19). The second study (20) was a school-based program for grade 6 and 7 students and consisted of lessons focused on reducing television viewing and consumption of high-fat foods, and increasing physical activity and fruit and vegetable consumption. After one year, students in the intervention schools were watching 0.6 h per day less television than students in the control schools (20). The third study (21) randomly assigned 90 obese children into one of four treatment groups, with each treatment consisting of educational therapy meetings with children and their parents. The meetings were provided in either a low or high dose and focused on either reducing sedentary behaviours or increasing physical activity. Following six months of treatment, targeted sedentary behaviours were significantly reduced in the group receiving the high dose of sedentary behaviour reduction therapy. However, the effects of the intervention were not as strong at 24-month follow-up (21).

Despite the demonstrated decreases in screen time, only one of the aforementioned intervention studies observed an increase in physical activity participation (21). Thus, although the overall goal of interventions should be to reduce total screen time to less than 2 h per day (7), emphasis must also be placed on increasing physical activity, so that time previously spent watching television and playing video games is not simply replaced by other sedentary behaviours such as reading or talking on the telephone with friends. The intervention should also incorporate guidelines for proper nutrition to help reduce snacking of calorically dense foods associated with television viewing (1,17).

Some limitations of the study should be noted. Television and computer use times were based on self-reports. It is also important to note that the survey did not ask specifically about video games that may be played on the television (eg, Nintendo, PlayStation). Although some students would have included this under the computer games question, others may not have, suggesting that total screen time may have been underestimated in the present study. Strengths of the study include the fact that it was based on a large data set that was representative of the Canadian school population. The derived measure of total screen time, including television and computer time, is also a strength, as the vast majority of previous studies have been limited to television use.

Fewer than 20% of Canadian school youth in grades 6 to 10 meet the total screen time guidelines. Public health interventions need to be introduced to reduce the number of leisure time hours that Canadian youth spend watching television and using the computer. Interventions should provide students with education concerning the benefits of regular physical activity, proper nutrition and appropriate social behaviours.

ACKNOWLEDGEMENTS

The present study was supported by the Public Health Agency of Canada (contract HT089-05205/001/SS), which funds the Canadian version of the World Health Organization – Health Behaviour in School-Aged Children Survey (WHO-HBSC). The WHO-HBSC is a WHO/Europe collaborative study. International Coordinator of the 2001/2002 study: Candace Currie, University of Edinburgh, Scotland; Data Bank Manager: Oddrun Samdal, University of Bergen, Norway. The present article reports data solely from Canada.

Footnotes

At first glance, this article may not seem fit for a theme issue on literacy. Deeper probing emphasizes the link. Tragically, for a great many urban and rural children, household poverty and illiteracy, along with the isolation of unsafe neighbourhoods and limited transportation, leads to hours of daily TV use, ‘the poor man’s entertainment’. In other households, it is simply the easiest activity to access, despite better alternatives. There is, of course, evidence that language and early literacy development in children aged two to five years can benefit from high-quality and age-appropriate educational programming. But excessive TV viewing is associated with negative outcomes for children and youth, including higher rates of obesity and poorer literacy. The core elements are quality and balance. Television should not serve as a substitute for child minding or interacting with a child, either because of child poverty or because of convenience. Television viewing can be habit-forming. Early and extensive indiscriminate television viewing can set the stage for later poor screen habits, with all of the negative health consequences.

Drs Noni MacDonald and Elizabeth Ford-Jones, Co-Editors-in-Chief

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