Factors influencing screen time in children aged 0-4 years old: a convergent parallel mixed-methods study.
8 affiliations
- 1Department of Health Promotion, Maastricht University, NUTRIM Institute of Nutrition and Translational Research in Metabolism, PO Box 616, Maastricht, 6200 MD, The Netherlands.
- 2Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands.
- 3Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
- 4Amsterdam Public Health, Methodology, Amsterdam, The Netherlands.
- 5Mulier Institute, Utrecht, The Netherlands.
- 6Public Health Service Amsterdam, Sarphati Amsterdam, Amsterdam, 1018 WT, The Netherlands.
- 7Department of Sociology, University of Amsterdam, Amsterdam, 1018 WV, The Netherlands.
- 8Department of Health Promotion, Maastricht University, NUTRIM Institute of Nutrition and Translational Research in Metabolism, PO Box 616, Maastricht, 6200 MD, The Netherlands. [email protected].
Abstract
Background
Young children are spending more time on screens at increasingly younger ages, with many exceeding current screen time recommendations. This mixed-methods study aimed to identify factors influencing screen time in children aged 0-4 years.Methods
As part of the My Little Moves study, we conducted a convergent parallel mixed-methods approach, incorporating a qualitative and quantitative sub-study. In the qualitative sub-study, we examined parental perspectives on which factors influence young children's screen time through focus group sessions. During these sessions, parents brainstormed on factors they considered to influence young children's screen time, first individually and thereafter in a group discussion. A thematic analysis using an inductive approach was used to identify categories of parent-perceived factors. In a separate quantitative sub-study, we collected parent-reported data on parental (e.g., rules around screen time) and environmental factors (e.g., play equipment) through online questionnaires, as well as parent-reported data on children's screen time through the My Little Moves app, at two timepoints. Robust linear mixed model analyses were used to examine longitudinal associations between factors and screen time.Results
In the qualitative sub-study, 22 parents listed 46 factors, which were categorized by researchers into: 8 child-related factors, 19 parent-related factors, and 16 environmental factors. The most frequently mentioned factor was screen use as an instrument to distract or occupy the child. In the quantitative sub-study, complete data were available for 107 children at timepoint 1 (mean age 21.3 ± 12.1 months) and 75 children at timepoint 2 (mean age 28.1 ± 10.6 months). Child age (β = 0.32; 95% CI = (0.22, 0.41)) and the parenting practice of using screen time to control or reward the child's behavior (β = 0.26; 95% CI = (0.16, 0.37)) were the only factors significantly associated with screen time, both with a moderate effect size.Conclusions
Findings from this study suggest that parental use of screen time to distract, reward, or control children's behavior contributes to increased screen time in 0-4-year-old children. These practices could be targeted to reduce screen time in early childhood.
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BibTeX
@article{arts2026factors,
title = {{Factors influencing screen time in children aged 0-4 years old: a convergent parallel mixed-methods study.}},
author = {Jelle Arts and Teatske M Altenburg and Sanne L C Veldman and Annelinde Lettink and Arnoud P Verhoeff and Mai J M Chinapaw and Jessica S Gubbels},
journal = {BMC public health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28901-0},
url = {https://europepmc.org/article/MED/42972311},
note = {CC BY},
}
RIS
TY - JOUR
TI - Factors influencing screen time in children aged 0-4 years old: a convergent parallel mixed-methods study.
AU - Jelle Arts
AU - Teatske M Altenburg
AU - Sanne L C Veldman
AU - Annelinde Lettink
AU - Arnoud P Verhoeff
AU - Mai J M Chinapaw
AU - Jessica S Gubbels
PY - 2026
DA - 2026/08/06
JO - BMC public health
DO - 10.1186/s12889-026-28901-0
UR - https://europepmc.org/article/MED/42972311
AB - Background Young children are spending more time on screens at increasingly younger ages, with many exceeding current screen time recommendations. This mixed-methods study aimed to identify factors influencing screen time in children aged 0-4 years.Methods As part of the My Little Moves study, we conducted a convergent parallel mixed-methods approach, incorporating a qualitative and quantitative sub-study. In the qualitative sub-study, we examined parental perspectives on which factors influence young children's screen time through focus group sessions. During these sessions, parents brainstormed on factors they considered to influence young children's screen time, first individually and thereafter in a group discussion. A thematic analysis using an inductive approach was used to identify categories of parent-perceived factors. In a separate quantitative sub-study, we collected parent-reported data on parental (e.g., rules around screen time) and environmental factors (e.g., play equipment) through online questionnaires, as well as parent-reported data on children's screen time through the My Little Moves app, at two timepoints. Robust linear mixed model analyses were used to examine longitudinal associations between factors and screen time.Results In the qualitative sub-study, 22 parents listed 46 factors, which were categorized by researchers into: 8 child-related factors, 19 parent-related factors, and 16 environmental factors. The most frequently mentioned factor was screen use as an instrument to distract or occupy the child. In the quantitative sub-study, complete data were available for 107 children at timepoint 1 (mean age 21.3 ± 12.1 months) and 75 children at timepoint 2 (mean age 28.1 ± 10.6 months). Child age (β = 0.32; 95% CI = (0.22, 0.41)) and the parenting practice of using screen time to control or reward the child's behavior (β = 0.26; 95% CI = (0.16, 0.37)) were the only factors significantly associated with screen time, both with a moderate effect size.Conclusions Findings from this study suggest that parental use of screen time to distract, reward, or control children's behavior contributes to increased screen time in 0-4-year-old children. These practices could be targeted to reduce screen time in early childhood.
SN - 1471-2458
ER -