382 - Parental use of routines, setting limits, and child screen use during COVID-19: Findings from a Canadian cohort study

Poster Number: 382
Publication Number: 382.87

Background: An increase in child screen time has been observed throughout the coronavirus disease 2019 (COVID-19) pandemic. Home environment, parental characteristics, and parenting practices have been associated with child screen time. To our knowledge, no study has explored the longitudinal association between routines and limit setting and screen time in children longitudinally during the COVID-19 pandemic.

Objective: To examine associations between and describe parental use of routines, limit setting, and child screen time before and during the COVID-19 pandemic.

Design/Methods: A cohort study was conducted in children aged 0-11 years though the TARGet Kids! primary care-practice based network in Toronto, Canada between May 2020 and May 2021. Repeated questionnaires were administered to parents to understand the impact of COVID-19 on children and families. Exposures included parent-reported use of routines and setting limits. Outcomes were parent-reported child daily screen time and met/did not meet the Canadian 24-Hour screen time guideline. Linear and logistic mixed-effects models were fitted using repeated measures of exposures and outcomes with a priori stratification by developmental stages ( < 3, 3-4.99, ≥5 years).

Results: A total of 700 children with 3,628 observations were included in this study (mean age=5.5 [SD=2.7, max=11.9] years, female=47.6%). Mean change in child screen time before versus during the pandemic was an increase of 51.1 minutes/day and level of parental use of routines and setting limits remained stable. Lower use of routines was associated with higher child screen time (β=4.0 minutes; 95%CI: 0.9, 7.1; p=0.01) in ages ≥5 years and lower odds of meeting the screen time guideline in ages < 3 years (OR < 3=0.59; 95%CI < 3: 0.38, 0.88; p< 3=0.01) and ≥5 years (OR≥ 5=0.76; 95%CI≥ 5: 0.67, 0.87; p≥ 5 < 0.01). Lower use of limit setting was associated with higher child screen time (β=3.8 minutes; 95%CI: 0.69, 6.48; p< 0.01) and lower odds of meeting the screen time guideline in ages ≥5 years (OR=0.86; 95%CI: 0.78, 0.94; p< 0.01).

Conclusion(s): Lower parental use of routines and limits during the COVID-19 pandemic were associated with higher screen time and lower odds of meeting the screen time guideline among school-age children. Strategies to promote parental use of routines and limit setting may play a positive role in helping children meet the screen time guideline among children 3 to 11 years of age.