Screen time patterns and associated factors among one to three year old urban children in Sri Lanka following COVID-19 pandemic

Excessive screen time is a significant global issue associated with adverse health outcomes. The most detrimental negative effects have been reported in the developing brains of very young children. In addition, the COVID-19 pandemic has further increased excessive screen time among all age groups. Many factors are associated with excessive screen time among young children. However, studies focusing on these factors in very young age groups are limited. This study aimed to determine the factors associated with screen time in young children aged one year to three years in an urban Sri Lankan setting. A clinic-based descriptive cross-sectional study was conducted in Kolonnawa, Sri Lanka, from January to March 2022 (post-COVID-19 era). The study included 511 primary caretakers and their children (aged 1–3 years) selected via cluster sampling. Screen time and associated factors were assessed using a self-administered questionnaire. The recommendations given by the American Psychological Association were used as cut-off points to define excessive screen usage (for children under 24 months of age, screen time of any amount per day was considered excessive, and for children older than 24 months, screen time of more than one hour per day was considered excessive). Binary logistic regression analysis was performed, and adjusted odds ratios (AOR) were calculated to determine the associations. The study population (N = 511) consisted of 253 (49.5%) male children. The mean age of the children was 22.2 months (SD ± 8.79). When the primary caretakers of the children were considered, the mean age of the mothers was 29.3 years (SD ± 3.90), while the fathers had a mean age of 32.1 years (SD ± 3.60). Among 369 children aged 24 months or younger, 298 (80.76%) had excessive screen time, whereas among 142 children who were more than 24 months old, 87 (61.27%) had excessive screen time. Excessive screen time was observed in 385 (75.34%) children. Younger age of the child (AOR = 1.16, p < 0.001), low maternal educational level (AOR = 2.50, p = 0.03), maternal (AOR = 0.48, p = 0.013) and paternal (AOR = 0.47, p = 0.009) excessive screen usage, having a television at home (AOR = 8.88, p < 0.001), and the availability of internet access at home (AOR = 1.96, p = 0.032) were significantly associated with excessive screen usage in young children. Excessive screen usage was high among children, with three out of four children spending more time in front of screens than the recommended amount. Further public health interventions, such as the development of context-specific policies and guidelines, are recommended to address this issue.