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      Changes and correlates of screen time in adults and children during the COVID-19 pandemic: A systematic review and meta-analysis

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          Abstract

          Background

          Screen time has increased as a result of the COVID-19 pandemic, and several correlates have been associated with these increases. These changes, however, have not been aggregated. It was the aim of this review to (a) aggregate changes in screen time in adults and children, and (b) report on variables in relation to screen time during the COVID-19 pandemic.

          Methods

          A systematic review of major databases was undertaken for studies published from inception to 06/12/2021, using a pre-published protocol (PROSPERO ID: CRD42021261422). Studies reporting (a) screen time pre-versus-during the pandemic, (b) screen time percentage change, or (c) correlates of screen time during the pandemic were included. A random effects meta-analysis was undertaken with subgroup analysis by age group and type of screen time.

          Findings

          After review, 89 studies ( n  = 204,734; median age=20·6; median female=53·3%) were included. The majority of studies were cross-sectional. With regards to total screen time, primary aged children (6–10 years) reported largest increases (1·4 hrs/day; 95%CI 1·1–1·7), followed by adults (>18 years; 1·0 hrs/day; 95%CI 0·7–1·2), adolescents (11–17 years; 0·9 hrs/day; 95%CI 0·3–1·5), and young children (0–5 years; 0·6 hrs/day 95%CI 0·3–0·9 hrs/day). For leisure screen time (non-work/non-academic), primary aged children reported largest increases (1·0 hrs/day 95%CI 0·8–1·3), followed by adults (0·7hr/day 95%CI 0·3–1·2), young children (0·6 hrs/day; 95%CI 0·4–0·8), with adolescents reporting the lowest increase (0·5 hrs/day 95%CI 0·3–0·7). Several correlates were associated with reported increases in screen time, including adverse dietary behaviours, sleep, mental health, parental health, and eye health.

          Interpretation

          Pooled evidence suggest that primary aged children reported the highest increase in both total and leisure screen time during COVID-19. It is recommended that screen time should be reduced in favour of non-sedentary activities. This study has the potential to inform public health policy and future guidance regarding screen time, and to inform future research in this area.

          Funding

          No funding was received for this study.

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          Most cited references134

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          Is Open Access

          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            Bias in meta-analysis detected by a simple, graphical test

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              Quantifying heterogeneity in a meta-analysis.

              The extent of heterogeneity in a meta-analysis partly determines the difficulty in drawing overall conclusions. This extent may be measured by estimating a between-study variance, but interpretation is then specific to a particular treatment effect metric. A test for the existence of heterogeneity exists, but depends on the number of studies in the meta-analysis. We develop measures of the impact of heterogeneity on a meta-analysis, from mathematical criteria, that are independent of the number of studies and the treatment effect metric. We derive and propose three suitable statistics: H is the square root of the chi2 heterogeneity statistic divided by its degrees of freedom; R is the ratio of the standard error of the underlying mean from a random effects meta-analysis to the standard error of a fixed effect meta-analytic estimate, and I2 is a transformation of (H) that describes the proportion of total variation in study estimates that is due to heterogeneity. We discuss interpretation, interval estimates and other properties of these measures and examine them in five example data sets showing different amounts of heterogeneity. We conclude that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity. One or both should be presented in published meta-analyses in preference to the test for heterogeneity. Copyright 2002 John Wiley & Sons, Ltd.
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                Author and article information

                Journal
                eClinicalMedicine
                EClinicalMedicine
                eClinicalMedicine
                The Author(s). Published by Elsevier Ltd.
                2589-5370
                21 May 2022
                June 2022
                21 May 2022
                : 48
                : 101452
                Affiliations
                [0001]Vision and Eye Research Institute (VERI), Anglia Ruskin University, Young Street, Cambridge CB1 2LZ, UK
                Author notes
                [* ]Corresponding author at: Vision and Eye Research Institute, Anglia Ruskin University, Cambridge CB1 2LZ, UK.
                Article
                S2589-5370(22)00182-1 101452
                10.1016/j.eclinm.2022.101452
                9122783
                35615691
                99d295b3-6674-4a2e-b6a2-79737dbc73e2
                © 2022 The Author(s)

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 10 November 2021
                : 13 April 2022
                : 27 April 2022
                Categories
                Articles

                covid-19,screentime,children,adults,review
                covid-19, screentime, children, adults, review

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