Abstract
Purpose: Screen use among adolescents is a growing concern due to its potential impact on health and wellbeing, including sleep. Different screen behaviors may affect these outcomes differently. This study used wearable cameras to objectively quantify evening screen use and describe screen behaviours among adolescents.
Methods: Adolescents aged 13–17 years (n=167) were recruited between 2017 and 2019 for the SNAP IT (Sleep, Nutrition, Activity Using Photo Images in Teens) study. Participants wore a Brinno TLC120 automated camera for three evenings (5 pm to bedtime), including one weekend evening. Cameras captured images every 15 seconds, and were reviewed to identify device types, and activities. Screen activities were categorized into passive (e.g., watching videos), interactive (e.g., gaming), and communication (e.g., texting). Multiple screen use, defined as using two or more devices simultaneously, was also identified.
Results: A total of 437 evenings were captured for 156 participants (58% girls), with a median of 1,030 images per participant (IQR: 774, 1,280) with a mean 258 min (SD: 100) per evening. Screens accounted for 58% of evening time, with only two participants reporting no screen use during any evening. Phones (21%), televisions (18%), and laptops (11%) were the most common devices. Most participants (84%) engaged in multiple screen use, averaging 40 min per evening. Boys spent more time on interactive screen activities (mean difference 36 min; 95% CI: 23, 50) compared to girls, and girls spent slightly more time on passive (mean difference 12 min; 95% CI: -4, 28; p=0.052) and communication activities (mean difference15 min; (8, 23, P<0.001). Screen time was higher on weekends than weekdays (mean difference 25 min; 95%CI: 9, 42) though the types of screen behaviours were consistent across days.
Conclusions: This study highlights the value of wearable cameras as a tool for objectively capturing real-world screen behaviours. Adolescents spent over half their evenings on screens, with widespread use of multiple devices.