Adolescents’ screen time exposure and the associated physical and psychological factors: an urban–rural perspective
Background Data exist on adolescents’ screen time behavior, but are lacking on urban–rural differences. We compared daily screen time exposures and associated anthropometric parameters, frequency of outdoor physical activity, and psychological parameters of urban and rural school-going adolescents. Methods This was a cross-sectional study. Using five districts of one of the administrative divisions of a western Indian state as the sampling frame, the first two urban and first two rural schools were selected from a randomly reordered list of schools. We included 627 students from 5th, 7th, and 9th standards as representatives of the adolescent age group (10–19 years). Self-reported outdoor physical activity, psychological assessment using the Strengths and Difficulties Questionnaire (SDQ) and daily time spent on each were recorded. We determined associations between area of residence, frequency of outdoor physical activity, and SDQ scores and screen time using the chi-square test or Fisher’s exact test. Multivariable regression analysis was used to determine the predictors of excessive screen time (>2 h/day). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated. Results There were 334 (53.3%) urban and 293 (46.7%) rural students. The mean age was 12.5 ± 1.4 years. Mean daily total screen time was 111.9 ± 71.7 min. Urban compared to rural [121.5 ± 75.9 min vs. 100.9 ± 65.0 min; p = 0.001] and boys compared to girls [122.9 ± 81.9 min vs. 100.9 ± 58.0 min; p < 0.000] had longer total screen time exposure. Being a rural resident was significantly associated with a >2 days/week of outdoor physical activity [78.8% (rural) vs. 35.9% (urban), respectively; OR 6.64, 95% CI 4.64–9.51, p < 0.000]. Students with daily screen time of >2 h had some/high needs on the SDQ hyperactivity scale [11.4% vs. 5.7%; p = 0.022]. Males had significantly higher odds of >2 h of total daily screen time than females (aOR = 1.51, 95% CI 1.05–2.17; p = 0.026). Conclusion The associations between longer screen time exposure and worse physical and psychological factors warrant interventions with special attention to urban–rural differences.