Electric screen time of urban preschoolers during and before COVID-19
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摘要:
目的 了解新冠肺炎疫情前及期间城市学龄前儿童各类电子屏幕使用时间及影响因素, 为控制学龄前儿童电子屏幕使用和预防近视提供科学依据。 方法 运用多阶段整群随机抽样法, 于2020年6—7月, 横断面调查上海市闵行区幼儿园8 244名儿童, 通过家长问卷收集学龄前儿童在新冠肺炎疫情暴发前后各类电子屏幕的使用时长, 估算加权屏幕屈光时间, 分析家庭电子屏幕督导行为与学龄前儿童加权屏幕屈光时间的关联。 结果 被调查学龄前儿童新冠肺炎疫情期间每日手机、电脑/平板、电视/投影视屏时长过度检出率分别为30.52%, 51.40%, 56.82%, 而疫情前上学日三者检出率分别为21.94%, 41.80%, 47.51%。控制重要混杂因素后, 家长控制孩子使用电子屏幕的频率高、家长对孩子使用电子屏幕时间有规定并严格实施与疫情前加权屏幕屈光时间负向关联(调整OR=0.60~0.77, P值均＜0.05);家长陪伴孩子时使用电子屏幕的频率高、家长对孩子使用电子屏幕时间有规定但实施不严格与加权屏幕屈光时间和疫情期间加权屏幕屈光时间增加正向关联(调整OR=1.18~1.80, P值均＜0.05)。 结论 城市学前儿童疫情前后电子屏幕用眼时长均过长。学龄前儿童视屏行为的控制措施中, 应注重家庭内部的电子屏幕使用管理和父母自身的榜样作用。 Abstract:Objective To determine the influencing factors of electronic screen time of urban preschoolers before and after the COVID-19 outbreak, so as to provide a scientific basis for the control of digital screen use and early prevention of myopia among preschoolers. Methods Using multi-stage cluster random sampling method, a cross-sectional survey of 8 244 kindergarten students in a district of Shanghai was implemented, through parent questionnaire collecting the time child spent on various electronic screens before and after the COVID-19 outbreak, estimated the weighting screen time, and emphatically analyzed the relationship between family electronic screen supervision behavior and preschoolers' weighting screen time. Results The proportion of daily over-use time on average of mobile phones, computers and TV/projection screens among the surveyed preschool children during COVID-19 was 30.52%, 51.40% and 56.82%, respectively. On school days before the epidemic, the proportion was 21.94%, 41.80% and 47.51% respectively. After controlling for primary covariates, parents' frequent control of children's electronic screen use, parents' guidance for electronic screen use were significantly associated with lower weighted screen refractive time (OR=0.60-0.77, P < 0.05). The use of electronic screen when parents accompanied their children, the use of electronic screen time by parents but not strictly implemented were significantly associated with higher weighted screen refractive time and increased screen refractive time (OR=1.18-1.80, P < 0.05). Conclusion Urban preschoolers' electronic screen time was high during and before COVID-19. In the control measures of preschool children's electronic screen time, attention should be paid to the management of electronic screen use within the family and parents' role model. -
Key words:
- Coronavirus /
- Fixation, ocular /
- Time /
- Regression analysis /
- Child, preschool
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同组别学龄前儿童新冠肺炎疫情前及疫情期间各类视屏时长过度检出率比较
Table 1. Distribution of various types of prolonged screen time in preschool children of different characteristics
组别 分类 人数 电视/投影 电脑/平板 手机 疫情前 疫情期间 χ2值 P值 疫情前 疫情期间 χ2值 P值 疫情前 疫情期间 χ2值 P值 年龄/岁 ≤4 2 895 1 389(47.98) 1 655(57.17) 756.88 ＜0.01 984(33.99) 1 253(43.28) 1 270.58 ＜0.01 581(20.07) 818(28.26) 1 263.10 ＜0.01 5 3 002 1 435(47.80) 1 712(57.03) 740.32 ＜0.01 1 342(44.70) 1 644(54.76) 1 082.39 ＜0.01 673(22.42) 932(31.05) 1 059.09 ＜0.01 ≥6 2 327 1 083(46.54) 1 306(56.12) 489.52 ＜0.01 1 112(47.79) 1 330(57.16) 763.31 ＜0.01 550(23.64) 760(32.66) 863.16 ＜0.01 性别 男 4 295 2 071(48.22) 2 432(56.62) 1 067.75 ＜0.01 1 759(40.95) 2 173(50.59) 1 652.83 ＜0.01 936(21.79) 1 307(30.43) 1 672.90 ＜0.01 女 3 929 1 836(46.73) 2 241(57.04) 916.96 ＜0.01 1 679(42.73) 2 054(52.28) 1 497.04 ＜0.01 868(22.09) 1 203(30.62) 1 500.17 ＜0.01 父母高度近视* 均不近视 6 641 3 196(48.13) 3 809(57.36) 1 534.80 ＜0.01 2 756(41.50) 3 380(50.90) 2 498.22 ＜0.01 1 541(23.20) 2 111(31.79) 2 557.87 ＜0.01 至少一方近视 1 505 673(44.72) 826(54.88) 428.27 ＜0.01 649(43.12) 810(53.82) 626.29 ＜0.01 235(15.61) 365(24.25) 585.18 ＜0.01 幼儿眼病病史 否 7 131 3 418(47.93) 4 082(57.24) 1 703.60 ＜0.01 2 970(41.65) 3 663(51.37) 2 706.14 ＜0.01 1 610(22.58) 2 241(31.43) 2 785.66 ＜0.01 是 1 093 489(44.74) 591(54.07) 278.02 ＜0.01 468(42.82) 564(51.60) 445.26 ＜0.01 194(17.75) 269(24.61) 374.20 ＜0.01 父亲文化程度 本科以下 3 479 1 761(50.62) 2 003(57.57) 749.94 ＜0.01 1 406(40.41) 1 646(47.31) 1 308.69 ＜0.01 1 088(31.27) 1 394(40.07) 1 204.44 ＜0.01 本科及以上 4 745 2 146(45.23) 2 670(56.27) 1 238.23 ＜0.01 2 032(42.82) 2 581(54.39) 1 842.48 ＜0.01 716(15.09) 1 116(23.52) 1 889.76 ＜0.01 母亲文化程度 本科以下 3 680 1 841(50.03) 2 116(57.50) 793.70 ＜0.01 1 450(39.40) 1 727(46.93) 1 359.89 ＜0.01 1 163(31.60) 1 485(40.35) 1 283.34 ＜0.01 本科及以上 4 544 2 066(45.47) 2 557(56.27) 1 194.33 ＜0.01 1 988(43.75) 2 500(55.02) 1 781.97 ＜0.01 641(14.11) 1 025(22.56) 1 785.55 ＜0.01 家长陪伴孩子时使用 不会或很少 1 373 526(38.31) 662(48.22) 321.48 ＜0.01 429(31.25) 576(41.95) 513.36 ＜0.01 205(14.93) 304(22.14) 429.34 ＜0.01 电子屏幕频率 偶尔 3 821 1 807(47.29) 2 204(57.68) 932.83 ＜0.01 1 561(40.85) 1 957(51.22) 1 496.25 ＜0.01 812(21.25) 1 142(29.89) 1 427.25 ＜0.01 经常 3 030 1 574(51.95) 1 807(59.64) 701.26 ＜0.01 1 448(47.79) 1 694(55.91) 1 103.33 ＜0.01 787(25.97) 1 064(35.12) 1 258.01 ＜0.01 家长控制孩子使用 经常 6 657 3 084(46.33) 3 822(57.41) 1 720.16 ＜0.01 2 719(40.84) 3 412(51.25) 2 585.90 ＜0.01 1 277(19.18) 1 887(28.35) 2 507.68 ＜0.01 电子屏幕频率 很少 1 567 823(52.52) 851(54.31) 287.79 0.20 719(45.88) 815(52.01) 568.87 ＜0.01 527(33.63) 623(39.76) 617.71 ＜0.01 家长对孩子使用电子 完全没有 251 126(50.20) 116(46.22) 56.82 0.27 101(40.24) 109(43.43) 98.09 0.30 64(25.50) 80(31.87) 90.45 0.02 屏幕时间的规定 规定执行不严格 4 993 2 778(55.64) 3 185(63.79) 997.74 ＜0.01 2 404(48.15) 2 841(56.90) 1 753.41 ＜0.01 1 437(28.78) 1 953(39.11) 1 819.43 ＜0.01 规定严格执行 2 980 1 003(33.66) 1 372(46.04) 802.45 ＜0.01 933(31.31) 1 277(42.85) 1 234.58 ＜0.01 303(10.17) 477(16.01) 1 055.12 ＜0.01 卧室安装电子屏幕 否 6 076 2 650(43.61) 3 280(53.98) 1 489.08 ＜0.01 2 548(41.94) 3 136(51.61) 2 280.32 ＜0.01 1 183(19.47) 1 708(28.11) 2 293.24 ＜0.01 是 2 148 1 257(58.52) 1 393(64.85) 444.40 ＜0.01 890(41.43) 1 091(50.79) 871.52 ＜0.01 621(28.91) 802(37.34) 843.33 ＜0.01 注： ()内数字为检出率/%；*项有缺失值。 
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表 2 学龄前儿童疫情前上学日各类电子屏幕使用时长分布
Table 2. The distribution of various types of electronic screen time among preschool children during school days before COVID-19
年级 电子屏幕 不看 ＜0.5 h 0.5~ < 1 h 1~ < 2 h 2~ < 3 h ≥3 h 小班
(n=2 358)手机 9(0.38) 892(37.83) 1 006(42.66) 325(13.78) 108(4.58) 18(0.76) 电脑/平板 18(0.76) 745(31.59) 803(34.05) 588(24.94) 186(7.89) 18(0.76) 电视/投影 18(0.76) 401(17.01) 804(34.10) 767(32.53) 320(13.57) 48(2.04) 中班
(n=2 899)手机 15(0.52) 1 076(37.12) 1 146(39.53) 471(16.25) 150(5.17) 41(1.41) 电脑/平板 26(0.90) 686(23.66) 951(32.80) 827(28.53) 347(11.97) 62(2.14) 电视/投影 33(1.14) 552(19.04) 926(31.94) 943(32.53) 388(13.38) 57(1.97) 大班
(n=2 967)手机 15(0.51) 1 037(34.95) 1 224(41.25) 481(16.21) 187(6.30) 23(0.78) 电脑/平板 32(1.08) 576(19.41) 949(31.99) 916(30.87) 418(14.09) 76(2.56) 电视/投影 24(0.81) 618(20.83) 941(31.72) 915(30.84) 409(13.78) 60(2.02) 注： ()内数字为构成比/%。
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表 3 学龄前儿童疫情前周末及节假日各类电子屏幕使用时长分布
Table 3. The distribution of various types of electronic screen time among preschool children during weekends and holidays before COVID-19
年级 电子屏幕 不看 ＜0.5 h 0.5~ < 1 h 1~ < 2 h 2~ < 3 h ≥3 h 小班
(n=2 358)手机 21(0.89) 801(33.97) 941(39.91) 383(16.24) 177(7.51) 35(1.48) 电脑/平板 29(1.23) 662(28.07) 732(31.04) 598(25.36) 285(12.09) 52(2.21) 电视/投影 56(2.37) 346(14.67) 613(26.00) 738(31.30) 491(20.82) 114(4.83) 中班
(n=2 899)手机 26(0.90) 955(32.94) 1 064(36.70) 521(17.97) 267(9.21) 66(2.28) 电脑/平板 59(2.04) 593(20.46) 796(27.46) 805(27.77) 521(17.97) 125(4.31) 电视/投影 76(2.62) 417(14.38) 744(25.66) 885(30.53) 638(22.01) 139(4.79) 大班
(n=2 967)手机 39(1.31) 912(30.74) 1 114(37.55) 575(19.38) 275(9.27) 52(1.75) 电脑/平板 72(2.43) 508(17.12) 744(25.08) 892(30.06) 604(20.36) 147(4.95) 电视/投影 71(2.39) 467(15.74) 709(23.90) 885(29.83) 668(22.51) 167(5.63) 注： ()内数字为构成比/%。
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表 4 学龄前儿童新冠肺炎疫情期间各类电子屏幕使用时长分布
Table 4. The distribtion of various types of electronic screen time among preschool children during COVID-19
年级 电子屏幕 不看 ＜0.5 h 0.5~ < 1 h 1~ < 2 h 2~ < 3 h ≥3 h 小班
(n=2 358)手机 25(1.06) 733(31.09) 954(40.46) 397(16.84) 198(8.40) 51(2.16) 电脑/平板 43(1.82) 636(26.97) 676(28.67) 590(25.02) 333(14.12) 80(3.39) 电视/投影 79(3.35) 327(13.87) 594(25.19) 662(28.07) 524(22.22) 172(7.29) 中班
(n=2 899)手机 30(1.03) 897(30.94) 1073(37.01) 521(17.97) 289(9.97) 89(3.07) 电脑/平板 93(3.21) 581(20.04) 703(24.25) 812(28.01) 553(19.08) 157(5.42) 电视/投影 114(3.93) 410(14.14) 743(25.63) 807(27.84) 655(22.59) 170(5.86) 大班
(n=2 967)手机 47(1.58) 880(29.66) 1 075(36.23) 573(19.31) 314(10.58) 78(2.63) 电脑/平板 104(3.51) 456(15.37) 705(23.76) 818(27.57) 678(22.85) 206(6.94) 电视/投影 122(4.11) 459(15.47) 703(23.69) 792(26.69) 673(22.68) 218(7.35) 注： ()内数字为构成比/%。
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表 5 不同特征学龄前儿童疫情前及期间加权屏幕屈光时间及变化的Logistic回归分析[OR值(OR值95%CI)，n=8 146]
Table 5. Logistic regression analysis of weighting screen time between groups in different characteristic among preschoolers [OR(OR 95%CI), n=8 146]
自变量 分类 疫情前 疫情期间 Δ疫情暴发前后 性别 男 1.00 1.00 1.00 女 1.00(0.91~1.09) 1.00(0.91~1.09) 1.07(0.98~1.17) 年龄/岁 ≤4 1.00 1.00 1.00 5 1.29(1.16~1.44)* 1.44(1.29~1.61)* 1.14(1.03~1.26)* ≥6 1.60(1.42~1.80)* 1.63(1.45~1.83)* 1.20(1.07~1.35)* 幼儿眼病病史 否 1.00 1.00 1.00 是 0.89(0.77~1.02) 0.80(0.70~0.92) 0.89(0.78~1.02) 父母高度近视a 均不近视 1.00 1.00 1.00 至少一方高度近视 0.90(0.80~1.01) 0.84(0.74~0.95)* 1.00(0.89~1.12) 父亲文化程度 本科以下 1.00 1.00 1.00 本科及以上 0.81(0.72~0.91)* 0.88(0.78~0.98)* 1.06(0.95~1.18) 母亲文化程度 本科以下 1.00 1.00 1.00 本科及以上 0.85(0.76~0.96)* 0.83(0.74~0.93)* 1.03(0.92~1.15) 家长陪伴孩子时使用电子屏幕 不会或很少 1.00 1.00 1.00 频率 偶尔 1.53(1.34~1.75)* 1.43(1.25~1.65)* 1.22(1.07~1.38)* 经常 1.67(1.45~1.92)* 1.67(1.44~1.93)* 1.30(1.13~1.48)* 家长控制孩子使用电子屏幕 很少 1.00 1.00 1.00 频率 经常 0.77(0.68~0.87)* 0.99(0.88~1.12) 1.18(1.05~1.32)* 家长对孩子使用电子屏幕时间 完全没有 1.00 1.00 1.00 的规定 有规定，但实行不严格 1.80(1.38~2.34)* 1.90(1.45~2.48)* 1.69(1.30~2.21)* 有规定，并且严格实行 0.60(0.46~0.78)* 0.64(0.48~0.84)* 1.15(0.88~1.52) 卧室安装电子屏幕 否 1.00 1.00 1.00 是 1.31(1.18~1.46)* 1.33(1.20~1.48)* 0.96(0.86~1.06) 注：采用Enter法将所有变量纳入分析，Δ的分析调整了疫情前加权屏幕屈光时间；a表示该项有缺失值；*P＜0.05。
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