A survey of screen exposure and analysis of related influencing factors in children aged 0-3 years old

Objective To investigate the screen exposure situation and its determinants of children aged 0-3 years old, so as to offer insights for intervening in children’s screen exposure. Methods A total of 1 797 children who received routine physical examinations in Shaoxing Women's Health Hospital from January 2024 to December 2024 were enrolled. We used a self-designed screen exposure questionnaire to collect demographic information for children, educational attainment of parents and main caregivers, contents of video screen exposure, and video devices. The screen exposure rate among children was analyzed, and a multivariable logistic regression model was used to analyze its influencing factors. Results Among the 1,797 children aged 0-3 years old, 935 were boys accounting for 52.03%, and 862 were girls accounting for 47.97%. The mean age was (21.81± 9.97) months old. 335 infants and toddlers had an average daily cumulative screen exposure > 1 hour over the past week, namely exposure to a screen with a exposure rate of 18.64%. Multivariable logistic regression analyses showed that the risk of screen exposure was higher with each one-year increase in the child's age (OR=1.90, 95% CI: 1.58-2.28), cartoons or nursery rhymes as the main video content (OR=2.09, 95% CI: 1.27-3.44; OR=1.75, 95% CI: 1.02-2.97, respectively), and watching videos during the period for meals or for parents doing housework, or before bedtime (OR=3.51, 95% CI: 2.08-5.92; OR=2.92, 95% CI: 1.75-4.88; OR=2.01, 95% CI: 1.16-3.49, respectively). In contrast, mothers with higher educational levels (OR=0.67, 95% CI:0.49-0.92) were associated with a reduced rate of screen exposure. Conclusion Among children aged 0-3 years old, their screen exposure was associated with their age, maternal educational level, screen content, and time of video watching. The departments should strengthen the education on screen exposure for older children and the mothers with lower education, while advocating for parents to scientifically and normatively manage screen content and time.