Determinants of Screen Time Among Children Under Five Years: A Cross Sectional Study (Preprint)

BACKGROUND Excessive screen time is detrimental to the child’s health. However, screen time situation among Malaysian children is poorly understood. OBJECTIVE This study aims to identify the prevalence and determinants of screen time among children under five years old using the latest WHO guidelines. METHODS A cross sectional design was used to randomly select 489 children from nine government health clinics. Total screen time and factors were assessed using validated self-administered questionnaires and analyzed using multiple logistic regression. RESULTS Results show an overall prevalence of 91.4% with a median of 3.00 hours (IQR: 1.36-5.04). Majority of children watched television (66%), followed by mobile phones (30%) and computers (4%). The determinants of screen time were Malay ethnicity, (AOR 3.56, 95% CI: 1.65-7.68), parental age of 30 years or more (AOR 3.12, 95% CI: 1.58-6.16), parental screen time exceeding 2 hours a day (AOR 2.42, 95% CI: 1.24-4.73), parent’s moderate self-efficacy to influence child’s physical activity (AOR 2.29, 95% CI: 1.01-5.20) and parent’s positive perception on influence of screen time on child’s cognitive well-being (AOR 1.15, 95% CI:1.01-1.32). CONCLUSIONS Parents played an important role in determining their child’s screen time. Future interventions that focus on the parents may ensure age appropriate screen time for their children.