How Screen Time May Affect Health-Related Quality of Life in Community-Dwelling Adults in Hong Kong: The Mediation Roles of Physical Activity and Loneliness

BACKGROUND: Population-based studies on the prevalence of screen-time based activities and their role in health-related quality of life (HRQoL) remain lacking. OBJECTIVE: This study aimed to examine the associations between screen time and HRQoL as well as the mediation roles of physical activity and loneliness in these relationships in community-dwelling adults. METHODS: A population-based survey was conducted through telephone interviews in Hong Kong. Participants (N = 1070) were asked about their status as internet gamers and social media users, time spent on internet games and social media, moderate-to-vigorous physical activities (MVPA), loneliness, and HRQoL (EQ-5D and EQ-VAS). Descriptive statistics, regression, and path analyses were conducted. RESULTS: The mediation models of status of social media users and internet gamers by age groups (younger adults: 18-65 years vs older adults: >65 years) showed that MVPA significantly fully mediated the effect of social media users on EQ VAS in younger adults, and partially mediated its effect on EQ-5D index in older adults. However, internet gamers were only associated with more loneliness and better EQ VAS in younger adults but not older adults. The mediation model of social media time among social media users by age groups showed that loneliness significantly and completely mediated the effect of social media time on EQ-5D index only in younger adults. CONCLUSIONS: Internet games and social media may have different roles in health-related behaviors and quality of life. The findings highlight the importance of recognizing the multifaceted influences of screen time on adults' well-being across ages.