screen time

Media Use Research

ECHO Media Use Research

Media Use

The ECHO Program is committed to understanding the factors that influence child health, well-being, and development. The ECHO Program’s uniquely diverse, nationwide research network collects information from more than 64,000 children and their families, including information about media habits and related health outcomes. This allows researchers to investigate the effects of digital media use on child health and well-being.

Resources

Visit these sites to learn more about media use and children.

Surgeon General: Social Media and Youth Mental Health

American Acadamy of Pediatrics: Constantly Connected: How Media Use Can Affect Your Child

QUESTIONS

For more information, please email the NIH at NIHKidsandEnvironment@od.nih.gov.
For media inquiries or to request an interview, contact Rebekah Yeager at rebekah.yeager@nih.gov. 

Social media and digital tools have become part of daily life for many children and adolescents. While these platforms may offer a number of benefits, excessive screen time and digital media use among children have also been associated with adverse physical, developmental, and mental health outcomes, including obesity, inadequate sleep, and depression and anxiety. More research is needed to understand the full impact of screen time and social media use during developmentally sensitive periods of childhood and adolescence.

What We're Learning

The ECHO Program has published more than 2,000 articles about the results of its research, including many that looked at screen time and social media.

Here are some research highlights:

Strong Friendships Matter More than Time Spent on Social Media for Adolescent Mental Health, ECHO Study Finds
February 2025
High-quality peer relationships were the strongest predictor of teen well-being, regardless of social media use, with a magnitude nearly three times as large as the association between social media use and poor mental health.

How Can Clinicians Help Parents Set Reasonable Boundaries for their Children’s Digital Media Use?
March 2023
Parents have varying knowledge and beliefs about regulating their children’s digital media use, but many are interested in learning more about this topic from materials provided by their child’s pediatrician.

Screen Time for Children Rose During COVID-19 Pandemic, Remained High After Restrictions Lifted
February 15, 2023
Increases in screen time among children during the COVID-19 pandemic persisted more than one year into the pandemic, even when school closures and other restrictions had been lifted.

During the COVID-19 Pandemic, Children's Screen Time Increased
August 19, 2022
Children’s screen time increased during the pandemic with Hispanic children and non-Hispanic Black children having the most noticeable increase in screen time.

Children Whose Parents Had Flexible Work Schedules and More Financial Security Were More Likely to Have Less Screen Time and More Sleep
July 19, 2022
Children with parents who were able to change their work schedules to care for their children during the pandemic had less screen time and slept longer at night compared to children with parents who were unable to adjust their work schedules due to stress about money and access to food.

 

NIH Study Finds Screen Time Increases in Children During the Pandemic Persisted After Restrictions Lifted

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Increases in screen time among children persisted more than one year into the pandemic, after many COVID restrictions had been lifted, according to a new study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

Excessive screen time may be associated with obesity-promoting health behaviors and adverse mental health. The COVID-19 pandemic initially led to widespread school closures, shelter-in-place laws, closures of recreational facilities and cancellation of youth sports, increases in the number of parents working from home, and social distancing recommendations, all of which may have impacted screen time among children.

“Our findings can help inform clinical guidelines that could aid parents and their children in re-establishing healthy media use habits,” said Monique Hedderson, PhD, of the Kaiser Permanente Northern California Division of Research. “Pediatricians can help parents reset family media use priorities and limits that may have relaxed during the early stages of the COVID-19 pandemic using tools like the American Academy of Pediatrics Family Media Plan.”

The study included 228 children between ages 4 to 12 and their parents from three ECHO cohorts across the United States. ECHO researchers surveyed parents about their children’s total, educational (not including remote school), and recreational screen time and examined trends in screen use before and at two points during the pandemic.

Dr. Hedderson and Assiamira Ferrara, MD, PhD, ECHO Program investigators at the Kaiser Permanente Northern California Division of Research, led this collaborative research published in JAMA Network Open.

Hedderson, M. et al. “Trends in screen time use among children during the COVID pandemic, July 2019 through August 2021.” JAMA Network Open. DOI:  10.1001/jamanetworkopen.2022.56157

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

New ECHO Research Investigates Increase in Screen Time for Children During the Pandemic

Posted on by Jodi Snare

Collaborative ECHO research led by Monique Hedderson, PhD and Assiamira Ferrara, MD, PhD, of the Division of Research at Kaiser Permanente Northern California, investigates the changes in screen time habits of children during the COVID-19 pandemic. The study found that total screen time among children ages 4 to 12 increased between December 2020 and April 2021 when school closures and lockdowns were widespread and remained even after several restrictions were lifted. The research, titled “Trends in screen time use among children during the COVID pandemic, July 2019 through August 2021,” is published in JAMA Network Open.

The study included 228 parent-child pairs from three ECHO cohorts across the United States (Colorado, California, and South Dakota). Parents reported their children’s screen time. The geographically, racially, and ethnically diverse participants ranged in age from 4 to 12 at the start of the study. ECHO researchers surveyed parents about their children’s media use before, during the early, and later periods of the pandemic. The study assessed total, educational (not including remote school), and recreational screen time and examined trends in screen use before and at two points during the pandemic.

Excessive screen time is associated with obesity-promoting health behaviors and adverse mental health. The COVID-19 pandemic initially led to widespread school closures, shelter-in-place laws, closures of recreational facilities and cancellation of youth sports, increases in parents working from home, and social distancing recommendations, all of which may have impacted screen time among children.

“Our findings can help inform clinical guidelines that could aid parents and their children in re-establishing healthy media use habits,” said Dr. Hedderson. “Pediatricians can help parents reset family media use priorities and limits that may have relaxed during the early stages of the COVID-19 pandemic using tools like the American Academy of Pediatrics Family Media Plan.”

Prior studies have reported screen time levels during the pandemic but were unable to document changes in screen time because most lacked pre-pandemic assessments. This study is among a handful of ECHO COVID-19 studies to include pre-pandemic assessments of screen use in order to document changes during the pandemic.

More studies are needed to determine whether the increases in screen time among children during the pandemic impacted longer term obesity and mental health outcomes in children. Future studies can also clarify whether there were specific types of screen time that adversely impacted children’s health during the pandemic.

Read the research summary.

During the COVID-19 Pandemic, Children’s Screen Time Increased

<< Back to Research Summaries

During the COVID-19 Pandemic, Children's Screen Time Increased

Authors: Traci Bekelman, et al.

 

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health.

 

What were the study results?

The study found that overall children’s screen time increased significantly during the pandemic with Hispanic children and non-Hispanic Black children having the most noticeable increase in screen time. The study didn’t find any significant increase in the amounts of sugary drinks and unhealthy snack foods children consumed during the pandemic, but it did find a more noticeable increase among Hispanic children and older children. The amount of time children spent asleep increased but only among children whose sleep time was below the recommended range before the pandemic.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What was the study's impact?

This study shows how the disruptions caused by the COVID-19 pandemic affected children’s daily lives. The results of this study suggest that the pandemic may have worsened sociodemographic disparities for some child health behaviors, particularly in relation to the amount of time children spent looking at screens. This research suggests that families may need more support to re-establish healthy routines and reduce the negative effects of the pandemic on their children’s health behaviors.

 

Why was this study needed?

For many children, public health measures to mitigate the spread of the COVID-19 pandemic disrupted their daily routines, and prevented them from using community resources, such as parks and organized sports. During the first few months of the pandemic, there were changes in children’s health behaviors—such as diet, screen time, physical activity, and sleep habits. However, there are limited data on what happened to children’s health behaviors after the earliest, most restrictive lockdown period. This is an important topic because children’s health behaviors have been linked to their overall mental and physical health, academic achievement, and quality of life.

 

Who was involved?

The study included 347 children between the ages of 4 to 12 years and their caregivers recruited from ECHO cohorts in California, Colorado, North Dakota, and New Hampshire. Of those participants, 47% percent were female, and 62% were non-Hispanic White.

 

What happened during the study?

ECHO researchers collected data on children’s diet, physical activity, screen time, and sleep habits before and during the pandemic. The researchers also surveyed caregivers on how they thought their children’s health behaviors had changed during the pandemic. This study also explored how sociodemographic factors affected children’s health behaviors to identify children who are more likely to experience less recommended changes in behaviors.

 

What happens next?

This research may help us identify ways to support families with children in future public health emergencies. The ECHO Program is currently working to study changes in other related health behaviors. This includes changes in how well children follow national dietary guidelines, use of social media, and bedtimes/wake-up times.

 

Where can I learn more?

Access the full journal article, titled “Health Behavior Changes during the COVID-19 Pandemic: A Longitudinal Analysis among Children,” in the International Journal of Environmental Research and Public Health.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published August 19, 2022

 

Access the associated article.

Download this summary

During the COVID-19 Pandemic, Children's Screen Time Increased

Read More Research Summaries about COVID

 

Changes in Body Mass Index (BMI) during the COVID-19 Pandemic

Authors: Emily Knapp, Aruna Chandran, et al.

 

Youth Well-being During COVID-19

Author(s): Courtney K. Blackwell, et al.

During the Pandemic, Children Whose Parents Had Flexible Work Schedules and More Financial Security Were More Likely to Have Less Screen Time and More Sleep

<< Back to Research Summaries

During the Pandemic, Children Whose Parents Had Flexible Work Schedules and More Financial Security Were More Likely to Have Less Screen Time and More Sleep

Authors: Traci Bekelman, Katherine Sauder, et al.

 

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health.

 

What were the study results?

Children with parents who were able to change their work schedule to care for their children during the pandemic had less screen time and slept longer at night. Children with parents who were stressed about money and access to food and therefore unable to change their work schedule, drank more sugary drinks, were less active, and slept less at night. Similar to pre-pandemic study results, what children ate and their level of physical activity differed by their age and sex.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What was the study's impact?

This study shows how children’s diet, physical activity, and sleep behaviors during the pandemic were linked to the work schedules and stress of their parents. Parents stressed about money may need help getting their kids to be more active, eat better, use technology less, and sleep more.

 

Why was this study needed?

The COVID-19 pandemic changed family habits and financial situations for many. ECHO researchers wanted to know how parents' coping strategies, stress, and financial situations affected their children’s health behaviors during the first seven months of the pandemic.

 

Who was involved?

This study included 3,315 children between 3 and 17 years from 50 ECHO cohorts across the United States. Information about the children’s sex, age, race, and ethnicity were reported by a parent or found in their medical records.

 

What happened during the study?

Parents answered questions about their child’s diet, physical activity, screen time, and sleep during the first seven months of the COVID-19 pandemic. The parents also described how they were personally coping with the pandemic and what they were most stressed about.

 

What happens next?

ECHO researchers will continue to look at how financial stress and parents’ work schedules affect children’s health behaviors. This will help guide future strategies to encourage healthy behaviors among children even during stressful times like a pandemic.

 

Where can I learn more?

Access the full journal article, titled “Sociodemographic Variation in Children's Health Behaviors During the COVID-19 Pandemic,” in Childhood Obesity.

 

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published July 19, 2022

 

Access the associated article.

Download this summary

During the Pandemic, Children Whose Parents Had Flexible Work Schedules and More Financial Security Were More Likely to Have Less Screen Time and More Sleep

Read More Research Summaries about COVID

Did COVID-19 pandemic experiences contribute to symptoms of traumatic stress in mothers in the U.S.?

Authors: Tracy Bastain, Amy Margolis, et al.

Changes in children sleep habits during the COVID-19 pandemic

Authors: Maristella Lucchini, et al.

 

Changes in Body Mass Index (BMI) during the COVID-19 Pandemic

Authors: Emily Knapp, Aruna Chandran, et al.

 

Youth Well-being During COVID-19

Author(s): Courtney K. Blackwell, et al.