Technology and digital media's influence on preschool children's sleep 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。这是令人担忧的，因为过度的TDM使用与健康有关 问题，如儿童超重和肥胖的风险较高。将TDM使用与 肥胖的风险还没有得到有力的证实，但睡眠是一个假设的中介， 调查TDM对儿童睡眠的任何影响也可能影响其他健康和发育结果 以前与儿童睡眠不良有关。过去对幼儿使用TDM的研究主要依赖于 家长报告的儿童的TDM的典型使用，导致两个过度和不足的TDM使用报告。的 因此，这些过去研究结果的有效性受到质疑。FLASH-TV是近年来发展起来的一项新技术 我们的团队被动地，客观地测量儿童对大型数字屏幕的观看情况，如电视或视频- 游戏机在本提案中，我们建议利用FLASH-TV沿着新的测量方法 儿童对移动的设备的使用情况，以有力地评估儿童在多个平台（电视、移动的）上对TDM的使用情况 设备和视频游戏机）在两个时间点（相隔12个月）的10天内进行。我们将联合收割机 TDM使用评估与强大的，有效的方法来测量儿童的睡眠（腕戴式acigraphy），在一个 4岁儿童的不同队列（n=200）。身高和体重将被收集在孩子和父母。 家长将报告家庭环境变量，假设影响儿童的TDM使用 (TDM父母的教养方式，家庭的TDM清单，父母对儿童TDM使用的结果期望，以及 邻里关系障碍）和睡眠（睡眠养育实践，儿童的睡眠卫生环境，父母的 对孩子睡眠的期望）。第一次，这些新颖的方法，以被动和客观的 测量儿童在家庭环境中多天内的TDM使用情况，使我们能够评估儿童在家庭环境中的TDM使用情况， 儿童TDM使用与儿童基线和12个月以上睡眠之间的儿童关联。本研究 设计也将使我们能够更有力地评估儿童TDM使用与其体重之间的关联 状态超过12个月，以及睡眠是否介导TDM和体重状态之间的关联。最后，我们将 探讨家庭和社会环境对儿童TDM使用和睡眠的影响， 纵向模型。为了促进协同作用和成本效益在这个计划赠款，队列 项目2将利用项目1中建立的模型，调查TDM使用对儿童健康的影响。 发展成果。一个数字评估核心将提供技术和处理支持， 所有项目的TDM和睡眠评估以及生物统计学和数据库管理核心将确保 统一变量、数据库完整性和统计支持。因此，该项目将有助于提供 第一个关于TDM使用对儿童睡眠和体重状况影响的可靠数据，为未来的指南提供信息。

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. This is concerning because excessive TDM use has been linked to health problems, such as higher risk of overweight and obesity among children. The pathways linking TDM use with risk of obesity have not been robustly established, but sleep is one hypothesized mediator that warrants investigation. Any impact TDM has on child sleep could also influence other health and developmental outcomes previously associated with poor sleep in children. 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 proposal 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) over 10 days at two time-points, 12 months apart. We will combine the novel TDM use assessment with robust, valid approaches for measuring children’s sleep (wrist-worn acigraphy) in a diverse cohort of 4-year old children (n=200). Height and weight will be collected on the children and parents. Parents will report on home environmental variables that are hypothesized to influence the child’s TDM use (TDM parenting practices, TDM inventory of the home, parents’ outcome expectations for child’s TDM use, and neighborhood disorder) and sleep (sleep parenting practices, child’s sleep hygiene environment, parents’ outcome expectations for child’s sleep). 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 and children’s sleep at baseline and over 12 mo. This study design will also allow us to more robustly assess the association between children’s TDM use and their weight status over 12 mo, and whether sleep mediates the association between TDM and weight status. Lastly, we will explore the association of the home and social environments on children’s TDM use and sleep in cross-sectional and longitudinal models. To promote synergy and cost-effectiveness within this program grant, the cohort established in project 1 will be leveraged by project 2 to investigate the impact of TDM use on children’s developmental outcomes. A Digital Assessment Core will provide the technology and processing support for the TDM and sleep assessments of all projects and a Biostatistics and Database Management Core will ensure harmonization of variables, database integrity, and statistical support. This project will thereby help provide the first robust data for the influence of TDM use on children’s sleep and weight status to inform future guidelines.