Predictors of Parental Barriers to Reduce Excessive Child Screen Time Among Parents of Under-Five Children in Selangor, Malaysia: Cross-sectional Study (Preprint)

Abstract

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.