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），包括看电视、玩电脑游戏和移动终端 在学龄前儿童中很常见。许多幼儿超过了建议的≤1小时/天 家长监督的TDM使用，这因性别和种族/民族而异。这是因为过度的 TDM的使用与不太理想的发展和健康问题有关。其中一些结果，如 睡眠，体重状况和执行功能可能是相互关联的，应该一起检查在一个 研究计划。然而，过去关于幼儿TDM使用的研究主要依赖于父母的报告， 儿童典型的TDM使用，导致TDM使用的过度报告和报告不足。调查结果的有效性 因此，这些过去的研究受到质疑。FLASH-TV是我们团队开发的新技术， 被动地、客观地测量儿童对大型数字屏幕（如电视或视频游戏机）的观看情况。 在这项研究计划中，我们建议利用闪烁电视沿着与新的方法来衡量儿童的 使用移动的设备，以稳健地评估儿童在多个平台（电视，移动的设备， 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）; 2）项目2中的发展（执行功能）和体重状况，而 确定任何保护作用的父母脚手架对儿童TDM的使用，和3）TDM使用的时间的影响 接近就寝时间对儿童睡眠、昼夜节律和执行功能的影响 3.将开发三个核心，以提供跨项目的协同作用，并允许采用具有成本效益的方法， 实现所有项目的目标。一个行政核心将监督各部门之间的沟通和协调。 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 在这三个项目中，生物统计学和数据库管理核心将开发和 监督数据库，统一变量，并为所有三个项目提供统计支持。一个4年的队列 老年儿童（n=200）和他们的父母将被确定为项目1的整体方案，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天内收集数据， 时间点，间隔12个月。项目2将利用相同的队列并测量儿童的执行功能 在三个时间段内，在观察实验室中使用稳健的方法， 点（基线、6个月和12个月）。一个独特的样本将被招募参加实验 研究项目3。第一次，这些新颖的方法来被动和客观地衡量儿童的 TDM在他们的家庭环境中使用了多天，使我们能够评估儿童内和儿童之间的 儿童TDM使用对儿童健康和发育结果的影响，以提供更有力的证据 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.