We successfully completed a pilot trial, demonstrating the effectiveness of our approach to participant recruitment, intervention implementation, and outcome assessments. Based on pilot experiences, adjustments were made to the definitive SCREENS trial, which was carried out successfully. In the full trial, we found that limiting digital screen use in families with children increased children's physical activity, while limiting adults' digital use had no causal effect on their activity patterns. Unexpectedly, we found no evidence that limiting screen use affected children's sleep duration or quality. We also discovered that adults experienced improvements in mental well-being and mood when limiting digital screen use during leisure time.
We developed new methodologies to assess digital screen use, including technological methodologies for objective assessment in free-living settings and a software package for data quality control, processing, analysis, and summarization. We also developed a parent- and self-reported questionnaire to characterize digital screen use behaviors and the digital environment in families.
Using these methodologies, we provided up-to-date data on children's screen use, prevalence of problematic screen use, recreational screen use of parents, the screen media environment, and social disparities across screen use factors. We found associations between parents' screen media habits, attitudes, household rules, and their children's recreational screen use. Parental smartphone addiction was consistently associated with more behavioral problems in their children.
