jueves, 15 de julio de 2010

Television and Video Viewing Time Among Children Aged 2 Years --- Oregon, 2006--2007



Television and Video Viewing Time Among Children Aged 2 Years --- Oregon, 2006--2007
Weekly
July 16, 2010 / 59(27);837-841



Excessive exposure of children to television and videos (viewing time) is associated with impaired childhood development (1) and childhood obesity (2). In 2001, the American Academy of Pediatrics (AAP) recommended that children watch no more than 1 to 2 hours of "quality programming" per day, and that televisions be removed from children's bedrooms (3). To determine the risk for excessive viewing time among children aged 2 years, CDC and the Oregon Public Health Division analyzed 2006 and 2007 data from the Oregon Pregnancy Risk Assessment Monitoring Survey follow-back survey (Oregon PRAMS-2), which was used to re-interview mothers who had participated in PRAMS. This report summarizes the results of that analysis, which indicated that, on a typical day, 19.6% of children aged 2 years spent ≥2 hours watching television or videos. A total of 18.2% of children had a television in their bedroom; these children were more likely to have ≥2 hours viewing time compared with children without a television in the bedroom (34.1% versus 16.3%). In multivariable analysis, ≥2 hours of viewing time was positively associated with the presence of a television in the child's bedroom, non-Hispanic black maternal race/ethnicity, fewer than four outings with the child during the preceding week, and was negatively associated with obtaining child care in a child care center. In Oregon, these findings support the AAP recommendations that health professionals, parents, and caregivers recognize the extent of children's media consumption, and that televisions be removed from children's bedrooms. Other states should consider conducting similar surveys.

PRAMS is a population-based surveillance system that collects data on maternal attitudes and experiences before, during, and immediately after delivery of a live infant. Mail and telephone surveys are administered by state health departments with support from CDC. Oregon has collected PRAMS data continuously since 1998. Since 2006, the Oregon Public Health Division has been re-interviewing Oregon PRAMS respondents when their children reach age 2 years. The Oregon PRAMS-2 survey includes questions on maternal and child health, health-care access and utilization, health-related attitudes and behaviors; and social conditions.* The mean age of children at time of survey completion was 25.1 months (range: 23.4--30.2 months).

Viewing time was based on response to the question, "In a typical day, how much time does your two-year-old spend watching TV or videos?" Possible responses included "None," "Less than 2 hours," and "2 hours or more." Viewing time was dichotomized to "≥2 hours" or "<2 hours" (combining the responses of "None" and "Less than 2 hours"). Mothers also were asked, "Is there a TV in your two-year-old's bedroom?" Possible associations with viewing time were tested for a group of selected characteristics, all of which were based on results from the Oregon PRAMS-2 survey except for race/ethnicity, which was derived from the birth certificate.† All responses were weighted to account for the complex survey design, nonresponse, and noncoverage. Multiple logistic regression was used to calculate adjusted prevalence ratios (APRs), which were estimated by adjusted odds ratios, and 95% confidence intervals for ≥2 hours viewing time. Variables were selected for the model based on significance (with p<0.05) in unadjusted prevalence ratios; additionally, mother's age was controlled for in the model. Statistical software was used to account for the complex sampling strategy.

The Oregon PRAMS-2 weighted survey response rate was 51.1% during 2006 and 62.5% during 2007. Among 1,911 Oregon PRAMS-2 surveys conducted in 2006 and 2007, a total of 39 surveys were excluded because the viewing time question was not answered. An additional four surveys, in which the mother's age at the time of Oregon PRAMS-2 survey completion was <18 years, were excluded to restrict the analysis and conclusions to households with adult mothers. The total number of respondents for analysis was 1,868.

For a typical day, respondent mothers reported that 19.6% of children aged 2 years had ≥2 hours of viewing time (Table). Compared with non-Hispanic white mothers, non-Hispanic black mothers were significantly more likely to report ≥2 hours viewing time by their children (18.6% versus 35.9%, respectively). Children with a television in the bedroom (reported by 18.2% of mothers) were significantly more likely to have ≥2 hours of viewing time (34.1%) compared with children without a television in the bedroom (16.3%). Children who went on fewer than four outings§ during the preceding week were significantly more likely to have ≥2 hours of viewing time (22.8%) compared with children who went on four or more outings (14.5%). Children who spent any time in a child care center were significantly less likely to have ≥2 hours viewing time (7.8%), compared with children not in child care (23.2%) and children who had other child care (18.6%).¶ Household income, maternal depressive symptoms, maternal body mass index (Table), marital status, maternal birthplace in the United States, maternal and spouse/partner employment status, sex of the child, and urban/rural residence were not significantly associated with the amount of viewing time.

The multivariable model included age, race/ethnicity, and education of the mother, the presence of a television in the child's bedroom, the number of outings with the child, reading to the child, and child care. Two or more hours of viewing time was positively associated with having a television in the child's bedroom (APR = 2.9), being a non-Hispanic black mother (APR = 1.9), and taking the child on fewer outings (APR = 1.6); viewing time was negatively associated with obtaining child care in a child care center (APR = 0.3). No significant interactions were observed between race/ethnicity and education that were associated with the amount of viewing time.

Reported by
KD Rosenberg, MD, AP Sandoval, MS, K Hedberg, MD, Oregon Public Health Div. B Cadwell, MSPH, Div of Applied Sciences, Scientific Education and Professional Development Program Office; JY Oh, MD, EIS Officer, CDC.

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Television and Video Viewing Time Among Children Aged 2 Years --- Oregon, 2006--2007

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