Factors Associated with Screen Time in Iranian Children and Adolescents: The CASPIAN-IV Study

BACKGROUND Prolonged screen time is frequent in children and adolescents. Implementing interventions to reduce physical inactivity needs to assess related determinants. This study aims to assess factors associated with screen time in a national sample of children and adolescents. METHODS This nationwide study was conducted among 14,880 students aged 6-18 years. Data collection was performed using questionnaires and physical examination. The World Health Organization-Global School Health Survey questionnaire was used. Logistic regression analysis was used to examine the relationship between demographic variables, socioeconomic status (SES), family structure, physical activity, unhealthy eating habits, body mass index, and mental distress with screen time. RESULTS The participation rate was 90.6% (n = 13,486), 50.8% were male, and 75.6% lived in urban areas. Mean (standard deviation) age of participants was 12.47 (3.36) years. The SES, eating junk foods, urban residence, and age had significant association with screen time, watching television (TV), and computer use (P < 0.05). With increasing number of children, the odds ratio of watching TV reduced (P < 0.001). Statistically, significant association existed between obesity and increased time spent watching TV (P < 0.001). Girls spent less likely to use computer and to have prolonged screen time (P < 0.001). Participants in the sense of worthlessness were less likely to watch TV (P = 0.005). Screen time, watching TV, and using computer were higher in students with aggressive behaviors (P < 0.001); screen time was higher in those with insomnia. CONCLUSIONS In this study, higher SES, unhealthy food habits, and living in urban areas, as well as aggressive behaviors and insomnia increased the risk of physical inactivity.