Excessive screen time interferes with the health and development of children. However, the screen time situation among Malaysian children remains poorly understood. This study aims to identify the prevalence and determinants of excessive screen time among children under five years in Selangor, Malaysia, using the latest World Health Organization guidelines. In this cross-sectional study, 489 parent–child dyads were randomly selected from nine government health clinics in Petaling district, Selangor. Total screen time and factors were assessed using validated self-administered questionnaires and analysed using multiple logistic regression. The overall prevalence of excessive screen time was 91.4% with a median of 3.00 h. The majority of children utilized television (66%), followed by handheld devices (30%) and computers (4%). Determinants of screen time identified were Malay ethnicity, (aOR 3.56, 95% CI 1.65–7.68), parental age of ≥30 years (aOR 3.12, 95% CI 1.58–6.16), parental screen time >2 h a day (aOR 2.42, 95% CI 1.24–4.73), moderate self-efficacy to influence a child’s physical activity (aOR 2.29, 95% CI 1.01–5.20) and the positive perception on the influence of screen time on a child’s cognitive wellbeing (aOR 1.15, 95% CI 1.01–1.32). Parents play an important role in determining their child’s screen time. Future interventions should focus on addressing parental determinants to ensure age-appropriate screen time.

Background Globally, there is an increasing prevalence of excessive screen time exposure among young children, including in Malaysia. Parents are advised to limit this exposure, but there are barriers for many of them to follow this recommendation. To date, there is a lack of research on the factors that cause these parental barriers. Objective This study aimed to determine the parental barrier toward the reduction of excessive child screen time and its predictors among parents of children aged younger than 5 years in the Petaling District, Selangor, Malaysia. Methods A cross-sectional study was conducted from April 2019 to June 2020 among 789 parent-child dyads attending child health clinics in the Petaling District. Validated self-administered questionnaires were used to capture information on sociodemographic, parental, child-related, and environmental factors and parental barriers. Stratified sampling with probability proportionate to size was employed. Data were analyzed using SPSS Statistics version 25 (IBM Corp). Descriptive analysis and bivariable analysis were performed before multiple linear regression was used to identify predictors of parental barriers. Results The overall mean score of parental barriers was 3.51 (SD 0.83), indicating that the average numbers of barriers experienced by parents were more than 3. The multivariable analysis showed that the predictors of parental barriers included monthly household income (adjusted β=–.03, 95% CI –0.05 to –0.02), parents who worked in public sectors (adjusted β=.18, 95% CI 0.06 to 0.29), positive parental attitude on screens (adjusted β=.68, 95% CI 0.58 to 0.79), low parent self-efficacy to influence child’s physical activity (adjusted β=–.32, 95% CI –0.43 to –0.20), and child screen time (adjusted β=.04, 95% CI 0.02 to 0.06). Conclusions The strongest predictor of parental barriers to reduce excessive child screen time was the positive parental attitude on screen time which could contribute to their abilities to limit child screen time. Thus, future intervention strategies should aim to foster correct parental attitudes toward screen time activities among young children.

Background High prevalence of excessive screen time among preschool children is attributable to certain parental factors such as lack of knowledge, false perception about screen time, and inadequate skills. Lack of strategies to implement screen time guidelines, in addition to multiple commitments that may hinder parents from face-to-face interventions, demands the need to develop a technology-based parent-friendly screen time reduction intervention. Objective This study aims to develop, implement, and evaluate the effectiveness of Stop and Play, a digital parental health education intervention to reduce excessive screen time among preschoolers from low socioeconomic families in Malaysia. Methods A single-blind, 2-arm cluster randomized controlled trial was conducted among 360 mother-child dyads attending government preschools in the Petaling district, who were randomly allocated into the intervention and waitlist control groups between March 2021 and December 2021. This 4-week intervention, developed using whiteboard animation videos, infographics, and a problem-solving session, was delivered via WhatsApp (WhatsApp Inc). Primary outcome was the child’s screen time, whereas secondary outcomes included mother’s screen time knowledge, perception about the influence of screen time on the child’s well-being, self-efficacy to reduce the child’s screen time and increase physical activity, mother’s screen time, and presence of screen device in the child’s bedroom. Validated self-administered questionnaires were administered at baseline, immediately after the intervention, and 3 months after the intervention. The intervention’s effectiveness was evaluated using generalized linear mixed models. Results A total of 352 dyads completed the study, giving an attrition rate of 2.2% (8/360). At 3 months after the intervention, the intervention group showed significantly reduced child’s screen time compared with the control group (β=−202.29, 95% CI −224.48 to −180.10; P<.001). Parental outcome scores also improved in the intervention group as compared with that in the control group. Mother’s knowledge significantly increased (β=6.88, 95% CI 6.11-7.65; P<.001), whereas perception about the influence of screen time on the child’s well-being reduced (β=−.86, 95% CI −0.98 to −0.73; P<.001). There was also an increase in the mother’s self-efficacy to reduce screen time (β=1.59, 95% CI 1.48-1.70; P<.001) and increase physical activity (β=.07, 95% CI 0.06-0.09; P<.001), along with reduction in mother’s screen time (β=−70.43, 95% CI −91.51 to −49.35; P<.001). Conclusions The Stop and Play intervention was effective in reducing screen time among preschool children from low socioeconomic families, while improving the associated parental factors. Therefore, integration into primary health care and preschool education programs is recommended. Mediation analysis is suggested to investigate the extent to which secondary outcomes are attributable to the child’s screen time, and long follow-up could evaluate the sustainability of this digital intervention. Trial Registration Thai Clinical Trial Registry (TCTR) TCTR20201010002; https://tinyurl.com/5frpma4b

Aims: Children below five years have been the target of screen time guidelines. The adverse health outcomes associated with it require focusing on prime strategies for reducing screen time. The current study reviews parental intervention strategies to reduce screen time among preschool-aged children. Design: Systematic review. Data sources: A total of five databases of the Cochrane register of controlled trials, CINAHL, Medline PubMed, and Scopus databases were searched from May 1 to 31, 2020. Review Methods: The keywords of “screen time”, “television”, “video”, “computer”, “mobile device”, “hand phone”, “media use”, “preschool-aged children”, “interventions”, and “strategies” used for search. The inclusion criteria are limited to specific study populations, intervention, comparison and outcomes (PICOs), language, and published study types. The quality of articles was assessed using the Cochrane Risk of Bias (RoB) tool. Results: A total of six studies that met the inclusion criteria were further analysed. It showed that besides providing knowledge and awareness regarding screen time, restrictive practices, offering alternative activities to parents and removing the screen from the child’s bedroom were the most common strategies used by successful studies. The duration of intervention between 6-8weeks was sufficient to observe screen time reduction, while face-to-face methods dominated the mode of delivery. Increasing parental self-efficacy, listing outcome expectations, and reinforcement strategies targeting both the parents and their home environment were beneficial in reducing screen time. Conclusion: Future screen time reduction studies could benefit from incorporating the above approaches for screen time reduction intervention among preschool children.

The outbreak of COVID-19 has affected the world with over two million cases globally.  Malaysia has witnessed over 5,000 with almost 100 deaths as of 22 April 2020. Knowledge on the incubation period of COVID-19 is scarce due to the novelty of the virus. The aim of this study was to determine the incubation period of COVID-19 infection in the district of Petaling in Malaysia. A cross-sectional study was conducted using secondary data from the Petaling District Health Office. We analysed data of laboratory-confirmed COVID-19 cases notified to the Petaling District Health Office between 3 February 2020 and 13 April 2020. Our study included 219 cases. The median incubation period of COVID-19 among the cases was five days (interquartile range 3.0-8.0). Four main clusters were identified, with significant difference found between two of the clusters. Cluster A has a shorter incubation period 3.5 (3.0-6.8) compared to cluster B as most of the confirmed cases knew the source of infection. COVID-19 incubation period in Petaling, Malaysia fits within the range estimated by the World Health Organization. Based on the upper value of the incubation period interquartile range in our study, the length of quarantine and period of contact tracing should be at least 8 days. This finding is in accordance with our current practice to control the spread of COVID-19

Background:The most common health planning theories described by literature reviews are rationalism, incrementalism, and mixed-scanning. The application of planning theories in health planning is essential to give planners a broader perspective and to ensure the aims of their programmes are achievable. Tobacco control programme is among the health programmes that has been well established at an international level whereby The Framework Convention on Tobacco Control (FCTC) and MPOWER package have served as a guide to the WHO member countries. However, the planning process of tobacco control programmes of each country are made based on further justifications and current situations of the respective countries. Marked differences in health planning theory approaches can be seen among low, middle and high income countries during the planning of tobacco programmes. Materials and Methods:A scoping review was done using online databases by choosing the most common health planning theories used and mentioned in literature reviews. With the exception of Antarctica, several low, middle and high income countries with comprehensive information on tobacco control programmes were taken as representatives. Search for articles were conducted via four major databases including Scopus, Science Direct, Google Scholar, and PubMed with additional information from guidelines and expert reports from official websites. Result:The three most common theories used in health planning are rationalism, incrementalism, and mix scanning. Differences in the application of these theories are seen among low, middle and high income countries. Rationalism and mixed scanning theory were mostly applicable in high and middle income countries whereas incrementalism is mostly being used in LIC. Conclusion:The application of health planning theories in tobacco control program may differ depending on factors that influence the planning process mainly the economic and political factors as well as support from key players.

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BACKGROUND Globally, there is an increasing prevalence of excessive screen time exposure among young children, including Malaysia. Parents are advised to limit this exposure but there are barriers for many of them to follow this recommendation. To date, there is a lack of studies on the factors that cause these parental barriers. OBJECTIVE This study aimed to determine the parental barrier towards the reduction of excessive child’s screen time and its predictors among parents of children under five years old in Petaling District, Selangor. METHODS A cross-sectional study was conducted from April 2019 to June 2020 among 789 parent-child dyads attending child health clinics in Petaling District, Selangor. Validated self-administered questionnaires were used to capture information on sociodemographic factors, parental influences, child-related factors, environmental factors, and parental barriers. Stratified sampling with probability proportionate to size was employed. Data were analysed with IBM SPSS version 25. Descriptive analysis and bivariate analysis were performed before multiple linear regression was used to identify the predictors of parental barriers. RESULTS The overall mean score of parental barriers was 3.51 ± 0.83, indicating that the average numbers of barriers experienced by parents were more than three. The multivariate analysis showed that the predictors of parental barriers included monthly household income (adjusted β: -0.031, 95% CI: -0.048 to -0.015), parents who worked in public sectors (adjusted β: 0.178, 95% CI: 0.063 to 0.292), positive parental attitude on screens (adjusted β: 0.684, 95% CI: 0.576 to 0.793), parents’ low self-efficacy to influence child’s physical activity (adjusted β: -0.318, 95% CI: -0.432 to -0.204), and child’s screen time (adjusted β: 0.042, 95% CI: 0.024 to 0.061). CONCLUSIONS The strongest predictor of the parental barriers to reduce excessive child’s screen time was the positive parental attitude on screen time. Thus, future intervention strategies should aim to foster correct parental attitudes towards screen time activities among young children.