Parents, Screens and outdoor play: Unpacking beliefs and practices for preschoolers in Karachi.

Objective: To explore parental beliefs and practices regarding the regulation of screen time and outdoor playtime among children aged 2-5 years in a densely populated urban setting in Pakistan. Study Design: Descriptive Cross-sectional study. Setting: In the Outpatient Clinics of (Secondary & Tertiary Care Setup) of a Private Hospital in Karachi. Period: July 2022 to December 2022. Methods: Interviews were conducted with 314 parents of children aged 2-5 years. Primary measures included parental practices and beliefs about screen time and outdoor playtime. Sociodemographic characteristics, parental practices, and beliefs were analyzed using frequencies and percentages; screen time durations were reported as means with standard deviations. Multivariate logistic regression was used to identify predictors of screen exposure. Results: A total of 69.4% of parents agreed that screen time for children under 5 years should be restricted to under 2 hours daily. Among participants, 60 parents (19.1%) reported no screen exposure for their children. Around two-third of parents (66.6%) used smart devices to occupy children during household tasks, and 68.2% believed these devices positively impacted learning, vocabulary, and responsiveness. More children had under 60 minutes of outdoor playtime on weekdays. Conclusion: This highlights a disconnect between parental awareness of screen time guidelines and actual practices, alongside limited outdoor play. Majority of the parents understood the need to regulate screen exposure, however Positive parental engagement to promote balanced screen use and increased physical activity is essential.