Leveraging passive objective assessment methods of preschooler's media use to examine multiple paths of influence on sleep, executive function and weight status

技术和数字媒体 (TDM)，包括观看电视、玩电脑游戏和移动设备 使用，在学龄前儿童中很常见。许多幼儿超过了建议的 ≤1 小时/天 家长监督 TDM 使用的比例，这因性别和种族/民族而异。这是令人担忧的，因为过多 TDM 的使用与不太理想的发育和健康问题有关。其中一些结果，例如 睡眠、体重状况和执行功能可能是相互关联的，应该同时进行检查 研究计划。然而，过去对幼儿 TDM 使用情况的研究主要依赖于家长的报告 儿童对 TDM 的典型使用，导致 TDM 使用的多报和少报。研究结果的有效性 因此，过去的这些研究受到质疑。 FLASH-TV是我们团队开发的一项新技术 被动、客观地测量儿童观看大型数字屏幕（例如电视或视频游戏机）的情况。 在本研究项目中，我们建议利用 FLASH-TV 以及测量儿童的新方法 移动设备的使用，以稳健地评估儿童跨多个平台（电视、移动设备、 和视频游戏机）。这将使我们能够调查 TDM 使用对 1) 健康结果（睡眠）的作用 和儿童体重状况）在项目1中； 2) 项目2的发展（执行职能）和权重状况，同时 确定父母支架对儿童 TDM 使用的任何保护作用，以及 3) TDM 使用时间的影响 使用项目中的实验研究，在接近就寝时间时对儿童睡眠、昼夜节律和执行功能进行研究 3. 将开发三个核心，以提供跨项目的协同作用，并采用具有成本效益的方法 实现所有项目的目标。行政核心将监督跨部门的沟通和协调 项目。数字评估核心将监督 TDM 使用和睡眠的被动和客观评估 在所有三个项目的儿童中。生物统计和数据库管理核心将开发和 监督数据库、协调变量并为所有三个项目提供统计支持。 4年组 项目 1 的总体方案将建立老年儿童（n=200）及其家长，以评估儿童的 TDM 使用、体重状况、睡眠和家庭环境。该队列将在 10 天内的两点收集数据 时间点，相隔12个月。项目 2 将利用同一队列来衡量孩子的执行功能 在观察实验室中使用稳健的方法进行 TDM 使用期间的亲子互动，跨越三个时间 点（基线、6 个月和 12 个月）。将招募一个独特的样本来参与实验 项目 3 的研究。这些新颖的方法首次被动地、客观地测量儿童的 在家庭环境中连续多天使用 TDM 使我们能够评估儿童内部和儿童之间的情况 儿童 TDM 使用与儿童健康和发育结果的关联，以提供更强有力的证据 为未来的儿童 TDM 指南提供信息。

Technology and digital media (TDM), which includes TV viewing, playing computer games, and mobile device use, is common among preschool aged children. Many young children exceed the recommended ≤1 hour/day of parent supervised TDM use and this varies by sex and race/ethnicity. This is concerning because excessive TDM use has been linked less desired developmental and health problems. Some of these outcomes, such as sleep, weight status and executive functioning may be interrelated and should be examined together in one research program. However, past studies of TDM use among young children primarily relied on parent report of children’s typical use of TDM, resulting in both over- and under-reporting of TDM use. The validity of findings from these past studies are therefore questioned. FLASH-TV is a new technology developed by our team to passively, objectively measure children’s viewing of large digital screens, such as TVs or video-game consoles. In this research program we propose to leverage FLASH-TV along with new approaches for measuring children’s use of mobile devices, to robustly assess children’s use of TDM across multiple platforms (TV, mobile devices, and videogame consoles). This will allow us to investigate the role TDM use has on 1) health outcomes (sleep and child weight status) in project 1; 2) development (executive function) and weight status in project 2, while identifying any protective role parental scaffolding has on child TDM use, and 3) the effect of timing of TDM use close to bedtime on child sleep, circadian rhythm, and executive function using experimental studies in project 3. Three cores will be developed to provide synergy across projects and allow for a cost effective approach to achieve the aims of all projects. An Administrative Core will oversee the communication and coordination across projects. A Digital Assessment Core will oversee the passive and objective assessment of TDM use and sleep among children across all three projects. The Biostatistics and Database Management Core will develop and oversee databases, harmonize variables, and provide statistical support for all three projects. A cohort of 4-year old children (n=200) and their parent will be established for the overall program by project 1 to assess the child’s TDM use, weight status, sleep, and home environment. The cohort will have data collected over 10 days at two time-points, 12 months apart. Project 2 will leverage the same cohort and measure the child’s executive function and parent-child interactions during TDM use using robust approaches in an observation lab across three time points (baseline, 6 months and 12 months). A unique sample will be recruited to participate in the experimental studies for project 3. For the first time, these novel approaches to passively and objectively measure children’s TDM use in their home environment over multiple days allows us to assess the with-in and between child association of children’s TDM use on child health and developmental outcomes to provide more robust evidence to inform future TDM guidelines for children.