Commentary on ‘Prevalence and Predictors of Screen Time Exposure in Young Children: A Descriptive, Facility-based Study’

A commentary has been published in this issue of the journal,[1] which provides a critique of a research article authored by us.[2] We sincerely appreciate the time and effort invested in post-publication peer review of our research study and highlighting aspects that may benefit from further clarification or elaboration. Through this article, we would like to provide responses to the concerns raised to ensure the robustness and transparency of our findings. To start with, we recognise that the title might suggest a focus solely on prevalence and predictors. However, it is clarified that the primary objectives of our study were to estimate the screen exposure time and identify associated risk factors among children aged 6 months–6 years. While a hospital-based study may not perfectly estimate the prevalence in the general population, it provides valuable insights within the hospital setting. The choice of a hospital-based design was due to logistical feasibility and the availability of a diverse patient population. Future studies could consider community-based designs to validate these findings. Second, the sample size calculation error with the standard deviation of 1.7.2 was a typographical mistake. Although the calculated minimum sample size was 129, in our research, we included 418 children, which enhanced the robustness of the findings. We acknowledge that this could be perceived as a deviation from standard practice and will be more transparent about such decisions in future publications. Third, a written, informed, valid consent was taken from the parents of the children from 6 months to 6 years of age. Informed consent included the details about the study, its risk benefit and confidentiality, all of these are mentioned in our published paper. We regret not mentioning about Participant Information Sheet. As per the ICMR guidelines, assent will be taken for age 7 years and above.[3] As our study involves minimal risk to the child, single-parent consent is also sufficient. We reiterate that our study approach fully adhered to the ethical standards and guidelines. Fourth, regarding the inclusion and exclusion criteria, our study included all children aged 6 months–6 years who visited the hospital during the study period, irrespective of their guardianship situation. The criteria were implicitly inclusive to cover diverse family situations. Fifth, the dependent variable in our study was screen time exposure, measured in minutes/day. Independent variables included factors such as parental occupation, educational level, socio-economic status and other demographic variables. We ensure these variables are clearly defined in the study.[4] Sixth, we agree that operational definitions are crucial. For our study, a ‘recent typical day’ refers to any regular weekday within the past month. Seventh, a pilot study was conducted to ensure clarity and appropriateness for the study population. Details of the validation process were omitted for brevity but can be included in future versions of the manuscript. Eighth, the data collection primarily involving mothers’, fathers’ and guardians’ roles was acknowledged. The results focused on mothers due to their pre-dominant role in child-rearing in the study population. Ninth, the outliers were identified based on extreme deviations from the mean screen time. We recognise the need to justify the exclusion of these data points and will provide a detailed rationale and method for outlier identification and handling.[5] We thank the Author of the commentary for insightful comments and critique of our work. Such constructive engagement strengthens the scientific discourse and allows for a more nuanced understanding of the complexities surrounding research in this field. Finally, we thank the Editor-in-Chief of the Preventive Medicine: Research and Reviews for facilitating this enriching academic exchange.