ECPN poster contestant: Understanding Indicators of Adequate Health Services in the Relationship Between Screen Time and Adolescent Obesity

Background

Overweight and obesity affects approximately 30% of adolescents in the United States, and is steadily increasing. Given the rising prevalence of pediatric obesity, efforts to pinpoint the barriers to maintaining a healthy weight are crucial. Previous research has identified a link between screen time and obesity; media use is directly associated with increased risks for obesity, but also discourages adolescent engagement in health promoting behaviors. Preventive medical visits may serve as a critical method of intervention by delivering valuable health information to adolescents about the reduction of obesogenic behaviors, like screen time. Yet, disparities within access, quality, and utilization of health care services may limit adolescents’ knowledge of preventive health behaviors, and potentially interact with media use to exacerbate adolescent obesity. As such, the aim of the present study is to explore associations between indicators of health services, screen time, and obesity. We hypothesize that high access, quality, and utilization of healthcare services may attenuate the relationship between screen time and adolescent obesity.

Method

The study analyzed data from the 2011-2012 National Survey of Children’s Health. Only adolescents 10-17 years-old (N= 45,309, 52.1% male, 67.3 % White, M_age = 13.63, SD = 2.325) were included in the study. Hierarchical logistic regression analyses were used to predict obesity status (dichotomized into obese or not obese) among adolescents. Associations between indicators of healthcare services, access, quality, and utilization, screen time, and obesity were explored.

Results

Greater amounts of screen time (OR 1.110, 95% CI 1.092, 1.128) and indicators of preventive health care: low access (OR .974, 95% CI .950, .999), low quality (OR .883, 95% CI .847, .921), and high utilization (OR 1.060, 95% CI 1.029, 1.093), were predictive of obesity status. Quality (OR 1.049, 95% CI 1.030, 1.070) and utilization (OR .985, 95% CI .971, .999) indicators of health services moderated the relationship between screen time and obesity status among adolescents, such that low quality and high utilization of health services strengthened the relationship between screen time and adolescent obesity status.

Conclusions

Findings suggest that having access to high quality health services, and low utilization of health services may attenuate the relationship between screen time and obesity. Given that screen time is directly related to other obesogenic behaviors such as poor dietary habits and sedentary behaviors, this finding demonstrates, as expected, that quality of preventive health visits can buffer the adverse effects of screen time on obesity. Yet, high utilization of health services for sick visits and preventive health visits does not buffer these effects, due to a lack of preventive information that is likely provided during sick visits. Future studies should investigate the associations between indicators of healthcare services and alternative types of obesogenic behaviors.