Square eyes or all lies? Investigating the methodology used in screen use research on children

Screen-based media devices, such as televisions, smartphones, and tablets, are integral to modern living. Children today are spending more time on screen-based media devices than ever before. However, the influence of these devices on children’s health outcomes remains controversial, with research showing inconsistent findings. Much of the inconsistency between studies may be due to the way screen use has been measured, as the field has largely relied on unvalidated self- or parent-reported measures. Automated wearable cameras present an opportunity to assess children’s screen use more accurately. The primary purpose of this thesis was to examine the use of automated wearable cameras to establish a more accurate measure of children’s screen use. The secondary purpose was to examine whether estimates of screen use from device-based measurements are similar to self-report measurements. Study 1 (Chapter 2) was a systematic review of the literature providing an overview of the evidence on the use of automated wearable cameras to measure health behaviours in youth. This study found that automated wearable cameras may provide a reliable method for measuring specific health behaviours; however, there was limited evidence on the validity of automated wearable camera measurements. Study 2 (Chapter 4) investigated the convergent validity of automated wearable camera measurements for measuring children’s screen use compared to direct observation. The findings from this study demonstrated that automated wearable camera measurements of screen use duration, type of device, social environment, content, associated behaviours, such as multitasking and eating, and location of the screen use show excellent agreement and strong convergent validity with direct observation measurements but poor agreement and weak convergent validity for food-related behaviours. Study 3 (Chapter 5) investigated whether estimates of screen use from the automated wearable camera measurements were similar to a self-report measure of screen use. The study found that parent- and child-reported screen use measurements were inaccurate compared to automated wearable camera measurements, with children and parents being more likely to overestimate their children’s screen use. The thesis’s implications, strengths, and limitations are discussed in Chapter 6. Overall, the findings of this thesis raise concerns about the accuracy of child- and parent-reported measurements of screen use. Given the challenge of accurately measuring children’s screen use behaviours; automated wearable cameras have the potential for accurately measuring complex screen use behaviours such as the content and context of the behaviour.

This work © 2024, Bridget Booker.