Effects of physical activity and screen-based sedentary behavior on children's mental health and academic performance

doi:10.21203/rs.3.rs-2900299/v1

Download PDF

Research Article

Effects of physical activity and screen-based sedentary behavior on children's mental health and academic performance

https://doi.org/10.21203/rs.3.rs-2900299/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Background: The present study examined the current status of physical activity and screen-based sedentary behavior among Chinese children aged 6-12 and explored the relationship between physical activity and screen-based sedentary behavior with children's mental health and academic performance.

Methods: Data were drawn from 2012 children aged 6-12 in three primary schools in China in 2020. Children's mental health was assessed by parents and teachers using the Strengths and Difficulties Questionnaire. Parents reported Children’s physical activity and screen-based sedentary behavior. Children's academic performance assessed by teachers. Binary logistic regressions were used to explore the effects of physical activity and screen-based sedentary behavior on children.

Results: Children aged 6-12 had an average of 2.9 hours of physical activity and 3.7 hours of screen-based sedentary behavior per week. Physical activity (>2h per week) was a protective factor for peer relationship problems (OR=0.62,95%CI:0.49-0.78) and internalizing problems (OR=0.65,95%CI:0.52-0.82) reported by parents. It was also associated with better reading skills (OR=1.33, 95%CI: 1.07-1.65). Screen-based sedentary behavior (>2 hours per week) was a risk factor for ADHD (OR=1.40, 95%CI:1.07-1.83) and externalizing problems (OR=1.28, 95%CI:1.01-1.61) reported by parents. And it was a protective factor for conduct problems (OR=0.65, 95%CI:0.44-0.97), peer relationship problems (OR=0.69, 95%CI:0.51-0.94) and internalizing problems (OR=0.69, 95%CI:0.52-0.93) reported by teachers.

Conclusions: Sufficient physical activity had benefits for children's mental health and academic performance. Screen-based sedentary behaviors longer than 2 hours per week had both beneficial and detrimental effects on different mental health problems, and we recommend that children avoid excessive screen time.

physical activity

screen-based sedentary behavior

children

mental health

academic performance

Substantial evidence has shown a persistent global trend of low physical activity and high sedentary behavior in Children^1,2. Physical activity is defined as any bodily movement generated by skeletal muscles that results in the expenditure of energy³. Sedentary behavior is defined as any waking behavior in which energy expenditure is less than 15 metabolic equivalents while sitting, lying or reclining⁴. Screen-based sedentary behavior, which includes watching television and playing video games, is becoming an important part of children's lives and is affecting their health⁵. The World Health Organization's 2020 guidelines on physical activity and sedentary behavior stated that an average of 60 minutes/day per week of moderate to vigorous intensity aerobic physical activity in children and adolescents is beneficial to health⁶. From 2004 to 2015, the rate of physical inactivity among children and adolescents aged 6–17 years in China increased by 5.5% and the amount of time spent on screen entertainment increased by 2.9 hours/week ⁷. The Chinese Physical Activity Guidelines (2021) stated that children and adolescents aged 6–17 should not be sedentary for more than one hour each time, and screen time should be less than two hours per day⁸.

Physical activity was beneficial to children's mental health, self-esteem levels, cognitive development and academic performance⁹. A review in 2019 concluded that promoting physical activity and reducing sedentary behavior may protect the mental health of children and adolescents¹⁰. Physical activity was found to have a small to moderate but sustained positive effect on depression in children and adolescents, and it might be a promising intervention for depression ¹¹. Another study indicated that higher physical activity in childhood was associated with lower attention-deficit hyperactivity disorder (ADHD) symptoms ¹². In addition, several studies showed a relationship between long-term exercise and children's academic performance ¹³, such as reading and mathematics¹⁴ and spelling ability¹⁵.

However, previous studies have shown different result about the relationship between screen-based sedentary behavior and mental health⁶.Several studies had demonstrated that screen-based sedentary behavior was associated with increased mental health risks¹⁶, for example, high levels of screen use were associated with higher rates of depression and anxiety disorders ^17–19. However, contrary to these findings, the results of one study showed that appropriate use of video games was a protective factor for peer relationship problems and was not associated with increased mental health risks. And it appeared to be associated with better intellectual functioning and academic achievement²⁰.

However, to date, most of the research on physical activity and sedentary behavior in China has focused on its effects on physical illnesses such as cardiovascular disease ,overweight and obesity ^21–23. Only a few studies explored the effects of physical activity and screen-based sedentary behavior on mental health. A study of Chinese students in Hong Kong showed a significant positive association between physical activity levels and mental health²⁴. Another study indicated that in Bengbu, China, about 26.1% of students were exposed to screens for more than 2 hours a day, which was far more than the time recommended by the guidelines. This study showed that high screen time was a risk factor for depressive symptoms, anxiety symptoms and school life dissatisfaction;in addition, adequate vigorous physical activity was a protective factor for depressive symptoms and school life dissatisfaction²⁵. But these studies were limited to students in junior high school students aged above 12 years.

This study aims to explore the effects of children's physical activity and screen time on mental health through a survey in children aged 6–12 conducted in Tianjin. Considering that physical activity and screen-based sedentary behavior also have a significant impact on children's academic performance, teachers' assessments of students' academic performance were also included in the study²⁶.

The objectives are (1) to investigate physical activity and screen-based sedentary behavior among primary school students (6–12 years old) and their associations; (2) to explore the effects of physical activity and screen-based sedentary behavior on mental health; and (3) the relationship between physical activity and screen-based sedentary behavior and children's academic performance. The current study hypothesized that low physical activity time and high sedentary activity time are often correlated and were risk factors for problems in Chinese children, and were detrimental to academic performance.

Participants and sampling

The participants were from three primary schools in Dongli District, Tianjin. Thirty-six primary schools in Dongli District were divided into three levels according to their location: urban, urban-rural and rural. One school in each level was then randomly selected. After passing the authorization of the school directors, the head teachers of each class were uniformly trained about the survey procedures. Class teachers then presented the details of the survey to the students' parents and informed them to sign an informed consent form via “Wechat”. Teachers distributed the consent form (in an envelope) to students in each class, and students took the envelope home to their parents. The child returned the signed consent form in an envelope to the class teachers. The signed consent forms were eventually given to the school directors, who checked them and forwarded them to the principal investigator. Data collection was performed between October and November of 2020. The teachers gave each child a parental questionnaire in a sealed bag. Children took the questionnaires home for their parents to fill in and returned them to the teacher in the sealed bag. After teachers had completed the teacher questionnaire, it was then mailed to the project leader along with the parent questionnaire. The children's privacy was protected throughout the project. Students who were not in school during the measurement day and those who refused to participate in the study will be excluded.

Measures

In each school, data were collected from children’s teacher and parents. Parents questionnaires allowed to gather information on the socio demographic context: the child’s age and gender, parental education (low, medium, high), marital status, household composition, occupational level (professionally active versus inactive) and family economic status. Teacher questionnaires were used to collect information about children's academic performance at school.

Physical activity and screen-based sedentary behavior

One parent was asked to fill in the amount of time that the child spent in physical activity and screen-based sedentary behavior out of school in the recent week. Screen-based sedentary behaviors in this article included watching television and playing video games. Based on the distribution and preliminary analysis of the data, the length of time for physical activity or screen time was divided into two levels: 0–2 hours per week and > 2 hours per week.

Children mental health status

The parent and teacher version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess Child psychopathology. The SDQ was developed and applied in the UK in 1997²⁷ by British child psychologist Goodman and then revised in 2001²⁸. The questionnaire consists of 25 items that assess five areas of conduct problems, ADHD, emotional symptoms, peer relationship difficulties and pro-social behavior. Generally, high scores represent greater difficulty, while the pro-social scale is represented by low scores. These five dimensions have also been divided into two subscales, the internalizing subscales and externalizing subscales. Emotional and peer relationship difficulties constitute internalizing problems, while ADHD and conduct problems constitute externalizing problems²⁹. The questionnaire was initially introduced into China by the Shanghai Mental Health Center and was tested for reliability and validity in the Shanghai region³⁰. Subsequently, SDQ was applied and tested in other regions of China, and the results showed good reliability and validity ³¹. The parent and teacher versions of the SDQ in this study had good psychometric properties. The alpha for the parent and teacher versions of the total difficulties scale was 0.74 and 0.84.

Academic performance

Children's academic performance was assessed through questions completed by the teacher by asking about the child's performance and learning behavior in the classroom. The assessment was carried out through two questions, one of which is “compared to the other children in the class, how does he or she fare in the following areas: school performance, reading, mathematics, spelling and intellectual functioning”. The question was classified into five levels, ranging from marked difficulties to very good. The other question was formulated as “Compared to the other children of the same class, would you say that: His/her motivation for succeeding at school”. This question was also be classified into five levels, ranging from very weak to very good.

Statistical analyses

Statistical analyses were performed using SPSS.25.0. Descriptive statistics, including means and percentages, were used to show the current status of children's physical activity and screen-based sedentary behavior in Tianjin. A chi-square test was used to test for demographic differences between physical activity and screen-based sedentary behavior categories. Univariate and multivariate logistic regression analysis were conducted to assess the association between children's physical activity and screen-based sedentary behavior and mental health/children's academic performance. The control variables were age, household economic status, parental education, marital status, the number of children in the family and urban/rural distribution of schools. Statistical significance was assessed using the 0.05 level. The ratios showed the corresponding 95% confidence intervals (95%CI).

Ethics statement

Written informed consent was completed by all participants and their guardians and participant privacy was protected throughout the process. The study was approved by the Ethics Committee of Tianjin Anding Hospital.

Sample characteristics

A total of 2012 students were included in this study. Finally, 1917 parents completed parent- questionnaire and 1889 students had their teachers’ reports. The average age of children was 9.03 years (SD=1.77 years). There were 1002(52.3%) boys and 915(47.7%) girls. The urban-rural distribution of children was urban (34.3%), urban-rural (39.0%), and rural areas (26.7%). The demographic information of the children was shown in Table 1.

Table 1

Physical activity and screen-based sedentary behavior

The average primary school student in Tianjin had 2.9 hours of physical activity per week and 3.7 hours of screen-based sedentary behavior. 34.3% of children spent more than two hours per week on physical activity and 41.6% engaged in screen-based sedentary behavior (watching TV or playing video games) for more than two hours per week.

It can be seen from Table 1 that most demographic characteristics were associated with physical activity and screen-based sedentary behavior. Children with longer physical activity time were associated with lower age, higher parental education level, wealthy family economic status, one child in the family and school located in urban. Conversely, factors associated with lower physical activity time were higher age, lower levels of parental education, difficult family economic status, more children in the home and schools located in rural areas. Children who spent more time using screens were Significantly associated with higher levels of parental education, one child in the family and schools located in urban. Conversely, children who spent less time using screens were significantly associated with lower levels of parental education, families with more children, and schools located in rural areas.

The impact of physical activity and screen-based sedentary behavior on children's mental health

Table2 shows the relationship between children's mental health and physical activity and screen-based sedentary behavior. High hours of physical activity (>2h) was a protective factor for peer relationship problems (OR=0.62,95%CI:0.49-0.78) and internalizing problems (OR=0.65,95%CI:0.52-0.82) as reported by the parental questionnaire. These associations persisted even after adjusting for the age, the educational level of the parents, marital status, the number of children in the family and the location of the school. However, questionnaires reported by teachers did not find a relationship between physical activity and mental health.

The relationship between screen time and children's mental health showed different results across different reporters. After adjusting for factors such as age, parental education level, marital status, number of children in the household, and school location, the results of the parent questionnaire showed that longer hours of screen-based sedentary behavior (>2 hours per week) were a risk factor for ADHD (OR=1.40, 95%CI:1.07-1.83) and externalizing problems (OR=1.28, 95%CI:1.01-1.61) in children.

But according to the results reported by the teacher questionnaire, it was a protective factor for conduct problems (OR=0.65, 95%CI:0.44-0.97), peer relationship problems (OR=0.69, 95%CI:0.51-0.94) and internalizing problems (OR=0.69, 95%CI:0.52-0.93).

Table 2

academic performance

School competences included competence in reading, mathematics, and spelling. More than two hours of physical activity per week was associated with better reading, math's and spelling skills in children. After adjusting for children's age, parents' education level, the number of children in the family, school location and marital status, only the relationship between reading and physical activity remained significant (OR=1.33,95%CI:1.07-1.65). There was no significant relationship between screen-based sedentary behavior and academic performance (Table 3).

Table 3

The joint effects of physical activity and screen-based sedentary behavior on mental health and academic performance

Based on the above studies, physical activity and screen time were known to have effects on ADHD, conduct problems, internalizing problems, externalizing problems and spelling skills. But the joint effects of different levels of physical activity and screen time on children are not clear. Therefore, we continued to investigate the effects of different levels of physical activity time on mental health and spelling skills at different levels of screen time. The results showed that low levels of physical activity (0-2h) and high levels of screen-based sedentary behavior (>2h) were risk factors for ADHD (OR=1.62,95%CI:1.11-2.35), conduct problems (OR=1.51,95%CI:1.00-2.26) and externalizing problems (OR=1.54,95%CI:1.12-2.12) as reported by parents. However, physical activity and screen-based sedentary behavior had no joint effect on teacher-reported child mental health（Table 4）.

Table 4

This study was aimed to investigate physical activity and screen-based sedentary behavior among Chinese primary school children and their relationship with mental health and academic performance. In order to study children's mental health more scientifically, we used both parents and teachers to report SDQ scores. The main findings from this study demonstrate that physical activity (> 2h per week) were beneficial in reducing the risk of some mental health problems reported by parents and were associated with good reading skills. Screen-based sedentary behavior (> 2h per week) was a risk factor for children's mental health problems reported by parents and a protective factor reported by teachers.

The current study indicated that primary students had averaged 2.9 hours of physical activity and 3.7 hours of screen-based sedentary behavior (watching TV or playing video games) per week. Compared to other countries, children in this study had lower levels of physical activity and screen time. For example, Australian children spend nearly 2.25 hours a day on sedentary activities such as watching TV/DVDs or playing video games ³². In the United States, physical activity averages 7.3–11.6 hours per week for boys and 8.0-11.2 hours per week for girls³³. The reasons for this phenomenon might be that children in China were allocated more time for learning and some parents didn’t pay enough attention to the amount of time their children spent participating in physical activities, resulting in a lack of physical activity. Parents were often more concerned about the harmful effects of screen use on children and strictly controlled the amount of time children spent on electronic entertainment, so the amount of time children in Tianjin spent on screens was mostly appropriate.

This study showed that more than two hours of physical activity per week for these primary school children was associated with a reduced risk of peer relationship problems and internalizing problems. And also associated with better reading skills. This finding is consistent with some previous studies. Canadian studies showed favorable associations between physical activity and mental health when all movement behavior recommendations in the Canadian 24- Hour Movement Guidelines for Children and Youth were met^34,35. One American study reported small to moderate positive associations between physical activity and positive mental health characteristics (social-emotional and academic functioning)³⁶.

In this study, screen-based sedentary behavior was a risk factor for children's ADHD and externalizing problems as reported by parents and a protective factor for conduct problems, peer relations and internalizing problems as reported by teachers. Most studies concluded that screen-based sedentary behavior is harmful to children's mental health and advocated for less screen time. A Canadian study reported longer screen time was associated with lower levels of satisfaction with life and optimism, and higher levels of anxiety and depressive symptoms; shorter screen time was associated with favorable mental health ³⁷. One study from China showed that screen-based recreational sedentary time was also detrimental to adolescents' cognitive flexibility³⁸. In our study, teacher-reported SDQ scores found that screen-based sedentary behavior of > 2 hours per week may have beneficial effects on mental health. This was because 96.6% of children in Tianjin used screens for less than 14 hours per week. The majority of children met the recommendations for screen time for children in China. This result indicated that appropriate screen time would have a beneficial effect on children⁸.

The results of this study showed that low levels of physical activity and high levels of screen-based sedentary behavior were risk factors for ADHD, conduct problems, and externalizing problems. Similar to our findings, an Icelandic study reported that less screen time (less than 5.3 hours/day) and more frequent vigorous exercise (4 times/week) were both associated with fewer symptoms of depression, anxiety, low self-esteem and life dissatisfaction³⁹. However, one article reported that screen time was not associated with mental health and that improving children's wellbeing through increased physical activity was more important than emphasizing the need to reduce screen time⁴⁰. The differences in the results of studies in different countries may be influenced by factors such as local cultural background and economic status, which can be further explored in the future.

Parents have an influence on their children's physical activity. Parental activity alone is not related to the child's physical activity, but activity in the presence of the child plays an important role in increasing the child's physical activity⁴¹. To increase children's physical activity, parents themselves need to be active participants, and family-based interventions to increase physical activity levels may be most effective if parents are encouraged to participate in physical activity with their children⁴².

Our study is not without limitations. Foremost, the assessment of mental health symptoms in this article was based on reports from parents and teachers rather than by clinicians. While the clinician's assessment would be informative, however, this study was primarily a screening for possible problems in children's mental health and the assessments of the two reporters increased the reliability. Secondly, the time of physical activity and sedentary behavior of the children was reported by the mothers. This might result in a lower accuracy of the final count. For example, children might avoid their parents to play video games, which results in parents observing such sedentary behavior for a shorter period of time than they actually do. The measurement of physical activity should be more objective and the use of small activity monitors to measure physical activity will make the results more accurate³⁹. Thirdly, due to the cross-sectional nature of this study, we were unable to determine the relationship between physical activity, sedentary behavior, mental health and academic ability.

The results of this study suggest that physical activity (> 2h per week) was beneficial to mental health and were associated with good reading skills in children. Screen-based sedentary behavior was differentially associated with parent- and teacher-reported children's mental health and was not significantly associated with academic performance.

Longitudinal studies are needed in the future to continue to monitor children's mental health and academic performance at the high school in order to draw conclusions about the long-term effects of physical activity and sedentary behavior. Children's daily activities not only include planned and organized physical activities but also more unstructured physical activities such as playing games, climbing and cycling. And different levels of physical activity may have different effects on mental health, for example higher levels of moderate to vigorous physical activity predicts a reduction in symptoms of major depression after 2 years ⁴³. Future directions for this research could start with a more detailed classification of physical activities and then explore the differences in the impact of different types and levels of physical activity on children's mental health.

SDQ

the Strengths and Difficulties Questionnaire.

Ethics approval and consent to participate

The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent was completed by all participants and their guardians and participant privacy was protected throughout the process. The study was approved by the Ethics Committee of Tianjin Anding Hospital.

Consent for publication

Not application.

Availability of data and materials

Data supporting the findings of this study are available on request from the corresponding author.

Competing interests

The authors declare that they have no competing interests.

Funding

This study was funded by Tianjin Key Medical Discipline (Specialty) Construction Project (TJYXZDXK-033A) and Tianjin Science and Technology Project (18ZXRHSY00100). These sources had no role in the design of the study and collection, analysis, interpretation of data, and writing the manuscript.

Authors’ contributions

Xuyang Su and Qiuping Yan participated in the design of the study, conducted the data analysis and wrote the first draft; Huifang Yin and Guangming Xu participated in the design of the study and revised the first draft; Viviane Kovess Masfety helped to revise the manuscript and provided valuable comments on the study; Peiyao Li, Minghui Li and Guoli Yan participated in the data collection and cleaning. All authors reviewed and approved the final version of the manuscript. All authors reviewed and approved the final version of the manuscript.

Acknowledgments

We thank all the clinicians and field staff who participated in the data collection and cleaning. In addition to this, we would like to give special thanks to the students, parents and teachers for their cooperation and active participation, which contributed greatly to this survey.

Authors’ information

¹Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University,Tianjin, China.²School of Education, Tianjin University, Tianjin, China.³LPPS, University of Pairs, France.⁴Department of Psychiatry, Mc Gill University, Montreal, Quebec, Canada.

Santaliestra-Pasías AM, Mouratidou T, Verbestel V, et al. Physical activity and sedentary behaviour in European children: The IDEFICS study. Public Health Nutr. 2013;17(10):2295–306. 10.1017/S1368980013002486.
Aubert S, Barnes JD, Abdeta C, et al. Global Matrix 3.0 physical activity Report Card grades for children and youth: Results and analysis from 49 countries. J Phys Act Heal. 2018;15(Suppl 2):251–S273. 10.1123/jpah.2018-0472.
Caspersen CJ, Powell KECG. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Heal Repes. Mar-Apr; 1985;10(2):126–31. 10.1093/nq/s9-IX.228.365-f.
Tremblay MS, Aubert S, Barnes JD, et al. Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act. 2017;14(1):1–17. 10.1186/s12966-017-0525-8.
Cai Y, Zhu X, Wu X. Overweight, obesity, and screen-time viewing among Chinese school-aged children: National prevalence estimates from the 2016 Physical Activity and Fitness in China—The Youth Study. J Sport Heal Sci. 2017;6(4):404–9. 10.1016/j.jshs.2017.09.002.
Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–62. 10.1136/bjsports-2020-102955.
YANG X, LEUNG AW, JAGO R, YU SC, ZHAO WH. Physical Activity and Sedentary Behaviors among Chinese Children: Recent Trends and Correlates. Biomed Environ Sci. 2021;34(6):425–38. 10.3967/bes2021.059.
Zhao W, Li K. Physical Activity Guidelines for Chinese (2021). Chin J Endem. 2022;53(2):5–6. 10.3760/cma.j.cn112338-20211119-00903.
Biddle SJH, Asare M. Physical activity and mental health in children and adolescents: A review of reviews. Br J Sports Med. 2011;45(11):886–95. 10.1136/bjsports-2011-090185.
Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López F, et al. Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis. Sport Med. 2019;49(9):1383–410. 10.1007/s40279-019-01099-5.
Wegner M, Amatriain-Fernández S, Kaulitzky A, Murillo-Rodriguez E, Machado S, Budde H. Systematic Review of Meta-Analyses: Exercise Effects on Depression in Children and Adolescents. Front Psychiatry. 2020;11(March):1–12. 10.3389/fpsyt.2020.00081.
Ganjeh P, Hagmayer Y, Meyer T, et al. Physical activity and the development of general mental health problems or attention-deficit hyperactivity disorder (ADHD) symptoms in children and adolescents: A cross-lagged panel analysis of long-term follow-up epidemiological data. Front Behav Neurosci. 2022;16. 10.3389/fnbeh.2022.933139.
Tomporowski PD, Davis CL, Miller PH, Naglieri JA. Exercise and children’s intelligence, cognition, and academic achievement. Educ Psychol Rev. 2008;20(2):111–31. 10.1007/s10648-007-9057-0.
Castelli DM, Hillman CH, Buck SM, Erwin HE. Physical fitness and academic achievement in third- and fifth-grade students. J Sport Exerc Psychol. 2007;29(2):239–52. 10.1123/jsep.29.2.239.
Pindus DM, Drollette ES, Scudder MR, et al. Moderate-to-vigorous physical activity, indices of cognitive control, and academic achievement in preadolescents. J Pediatr. 2016;173:136–42. 10.1016/j.jpeds.2016.02.045.
Iannotti RJ, Janssen I, Haug E, et al. Interrelationships of adolescent physical activity, screen-based sedentary behaviour, and social and psychological health. Int J Public Health. 2009;54(SUPPL 2):191–8. 10.1007/s00038-009-5410-z.
Twenge JM, Campbell WK. Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Prev Med Reports. 2018;12:271–83. 10.1016/j.pmedr.2018.10.003.
Maras D, Flament MF, Murray M, et al. Screen time is associated with depression and anxiety in Canadian youth. Prev Med (Baltim). 2015;73:133–8. 10.1016/j.ypmed.2015.01.029.
Teychenne M, Costigan SA, Parker K. The association between sedentary behaviour and risk of anxiety: A systematic review Health behavior, health promotion and society. BMC Public Health. 2015;15(1). 10.1186/s12889-015-1843-x.
Kovess-Masfety V, Keyes K, Hamilton A, et al. Is time spent playing video games associated with mental health, cognitive and social skills in young children? Soc Psychiatry Psychiatr Epidemiol. 2016;51(3):349–57. 10.1007/s00127-016-1179-6.
Lv Y, Cai L, Gui Z, et al. Effects of physical activity and sedentary behaviour on cardiometabolic risk factors and cognitive function in children: protocol for a cohort study. BMJ Open. 2019;9(10):1–9. 10.1136/bmjopen-2019-030322.
Li F, Mao L, Chen P. Physical activity and prevention of chronic disease in Chinese youth: A public health approach. J Sport Heal Sci. 2019;8(6):512–5. 10.1016/j.jshs.2019.06.008.
Liu H, Bi C, Lin H, et al. Compared with dietary behavior and physical activity risk, sedentary behavior risk is an important factor in overweight and obesity: evidence from a study of children and adolescents aged 13–18 years in Xinjiang, China. BMC Pediatr. 2022;22(1):1–12. 10.1186/s12887-022-03646-y.
Ho FKW, Louie LHT, Chow CB, Wong WHS, Ip P. Physical activity improves mental health through resilience in Hong Kong Chinese adolescents. BMC Pediatr. 2015;15(1):1–9. 10.1186/s12887-015-0365-0.
Cao H, Qian Q, Weng T, et al. Screen time, physical activity and mental health among urban adolescents in China. Prev Med (Baltim). 2011;53(4–5):316–20. 10.1016/j.ypmed.2011.09.002.
Huang X, Zeng N, Ye S. Associations of sedentary behavior with physical fitness and academic performance among chinese students aged 8–19 years. Int J Environ Res Public Health. 2019;16(22). 10.3390/ijerph16224494.
Goodman R. The strengths and difficulties questionnaire: A research note. J Child Psychol Psychiatry Allied Discip. 1997;38(5):581–6. 10.1111/j.1469-7610.1997.tb01545.x.
Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337–45. 10.1097/00004583-200111000-00015.
Goodman A, Lamping DL, Ploubidis GB. When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the strengths and difficulties questionnaire (SDQ): Data from british parents, teachers and children. J Abnorm Child Psychol. 2010;38(8):1179–91. 10.1007/s10802-010-9434-x.
Du Y, Kou J, Coghill D. The validity, reliability and normative scores of the parent, teacher and self report versions of the Strengths and Difficulties Questionnaire in China. Child Adolesc Psychiatry Ment Health. 2008;2:1–15. 10.1186/1753-2000-2-8.
Liang L, Yang J, Yao S. Measurement equivalence of the SDQ in Chinese Adolescents: A horizontal and longitudinal perspective. J Affect Disord. 2019;257:439–44. 10.1016/j.jad.2019.06.049.
Australian Bureau of Statistics. Australian health survey: physical activity 2011–12. Canberra: ABS; 2013.
Kahn JA, Huang B, Gillman MW, et al. Patterns and Determinants of Physical Activity in U.S. Adolescents. J Adolesc Heal. 2008;42(4):369–77. 10.1016/j.jadohealth.2007.11.143.
Sampasa-Kanyinga H, Sampasa-Kanyinga H, Colman I, et al. Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: A systematic review. Int J Behav Nutr Phys Act. 2020;17(1):1–16. 10.1186/s12966-020-00976-x.
Tremblay MS, Carson V, Chaput JP, et al. Canadian 24-hour movement guidelines for children and youth: An integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab. 2016;41(6):311–S327. 10.1139/apnm-2016-0151.
Hosker DK, Elkins RM, Potter MP. Promoting Mental Health and Wellness in Youth Through Physical Activity, Nutrition, and Sleep. Child Adolesc Psychiatr Clin N Am. 2019;28(2):171–93. 10.1016/j.chc.2018.11.010.
Oberle E, Ji XR, Kerai S, Guhn M, Schonert-Reichl KA, Gadermann AM. Screen time and extracurricular activities as risk and protective factors for mental health in adolescence: A population-level study. Prev Med (Baltim). 2020;141:106291. 10.1016/j.ypmed.2020.106291.
Cui J, Li L, Dong C. The associations between specific-type sedentary behaviors and cognitive flexibility in adolescents. Front Hum Neurosci. 2022;16(August):1–8. 10.3389/fnhum.2022.910624.
Hrafnkelsdottir SM, Brychta RJ, Rognvaldsdottir V, et al. Less screen time and more frequent vigorous physical activity is associated with lower risk of reporting negative mental health symptoms among Icelandic adolescents. PLoS ONE. 2018;13(4):1–15. 10.1371/journal.pone.0196286.
Matin N, Kelishadi R, Heshmat R, et al. Joint association of screen time and physical activity on self-rated health and life satisfaction in children and adolescents: The CASPIAN-IV study. Int Health. 2017;9(1):58–68. 10.1093/inthealth/ihw044.
Keyes BL, Wilson KS. Influence of Parental Physical Activity and Sedentary Behavior on Young Children: Considering Time Together. Res Q Exerc Sport. 2021;92(3):311–20. 10.1080/02701367.2020.1727405.
Lu C, Stolk RP, Sauer PJJ, et al. Factors of physical activity among Chinese children and adolescents: A systematic review. Int J Behav Nutr Phys Act. 2017;14(1):1–10. 10.1186/s12966-017-0486-y.
Zahl T, Steinsbekk S, Physical Activity. Sedentary Behavior, and Symptoms of Major Depression in Middle Childhood. 2017;139(2). doi:10.1542/peds.2016-1711.

Tables 1 to 4 are available in the Supplementary Files section

No competing interests reported.

Tables.docx

Download PDF

Version 1

posted

You are reading this latest preprint version

Effects of physical activity and screen-based sedentary behavior on children's mental health and academic performance

Status:

Version 1

Abstract

Background

Methods

Participants and sampling

Measures

Physical activity and screen-based sedentary behavior

Children mental health status

Academic performance

Statistical analyses

Ethics statement

Results

Discussion

Conclusions

Abbreviations

Declarations

References

Tables

Additional Declarations

Supplementary Files

Status:

Version 1