Abstract
AbstractObjectiveTo assess the independent effects of lifecycle (age), historical (period), and generational (cohort) differences that influence the trends in extreme (>3 hours/day) screen time (TV watching plus computer use) among school-aged children in the United States. Study designWe used data from the National Health and Nutrition Examination Survey (NHANES) and hierarchical age–period–cohort (HAPC) statistical techniques to decompose, describe, and explain the population-level, secular patterns in extreme daily screen viewing time among 5–15-year-olds between 1999 and 2018. ResultsWe found that 58% of school-aged children engaged in extreme daily screen time. The probability of extreme screen time is higher with each additional year of age, and those children aged 5–15 years old who belong to earlier-born cohorts have higher odds of extreme screen time compared with those of children from more recent birth cohorts. Specifically, for each additional annual increase in age, the probability of engaging in extreme screen time increases by nearly 40%, but this increase slows at the rate of 1% with every passing year throughout the life course. Regarding the negative cohort effect, we observed a decline in the predicted probabilities of extreme screen time among those born after 1995, with the lowest point among the 2000 birth cohort. Also, our results suggest that child and family sociodemographics, as well as the household economic environment and family structure, are associated with extreme screen time. ConclusionPopulation-level and family-based initiatives should focus on preventing the escalation in the amount of screen time exposure with increasing age.