Associations of Parental KAP Regarding Children's Screen Exposure, Home Nurture Environment, Parent–Child Screen and Parent–Child Interaction in Children Aged 2–3 Years: A Structural Equation Modelling

BACKGROUND: Early childhood development is profoundly influenced by parent-child interaction yet the impact of parental knowledge, attitude and practice (KAP) regarding screen exposure and home environment on these dynamics remains underexplored. This study investigates the associations between parental KAP on screen exposure, home nurture environment and parent-child interaction quality in children aged 2-3 years, addressing a critical gap in understanding how digital media habits shape early developmental contexts. METHODS: A cross-sectional study was conducted with 252 parents of children aged 2-3 years. Data were collected through validated questionnaires assessing parental KAP on screen exposure, parent-Child screen, home nurture environment and parent-child interaction quality. Structural equation modelling was employed to analyze direct and indirect pathways between variables. RESULTS: Parent-child screen exhibited a significant positive direct effect on parent-child interaction (β = 0.540, p < 0.01). The child home nurture environment had a significant positive direct effect on parent-child interaction (β = 0.366, p < 0.01) and also exerted an indirect positive effect on parent-child interaction through parent-child screen (β = 0.320, p < 0.01). Parental KAP regarding children's screen exposure exerted an indirect positive effect on parent-child interaction (β = 0.440, p < 0.01) through two pathways: one through the single mediating effect of child home nurture environment, and the other through the chain mediating effect from the child home nurture environment to parent-child screen. CONCLUSIONS: Supportive home environment and proactive parental engagement are pivotal in fostering positive parent-child interaction amidst rising screen exposure. Interventions targeting KAP improvement and balanced screen-use practices could enhance early childhood development. This study underscores the need for policy and educational programs to empower parents in creating nurturing, screen-smart home environment for early childhood.