Abstract
Objective To investigate the current status of screen device usage among children aged 3~6 years and to analyze the associated influencing factors, providing a scientific basis for guiding rational screen use and formulating targeted interventions for young children. Methods A cross-sectional study was conducted among 2,969 children aged 3~6 years. Data regarding demographic characteristics, screen usage behaviors, home environment, and caregiver information were collected via questionnaires. Univariate analysis was performed using the c2 test, and independent influencing factors were identified through a multivariable logistic regression model. Results Among the 2,969 children surveyed, the prevalence of screen exposure was 77.16%. Specifically, 54.97% were exposed to screens before the age of 3, 23.37% possessed dedicated screen devices, 45.27% engaged in viewing short videos, and only 19.13% could terminate usage voluntarily. Multivariable logistic regression analysis revealed that independent influencing factors for screen usage included: only-child status (OR=0.79, 95% CI: 0.62~1.01), caregiver education level of high school/associate degree (OR=0.70, 95% CI: 0.52~0.94) or bachelor’s degree and above (OR=0.44, 95% CI: 0.32~0.60), possession of dedicated screen devices (OR=2.39, 95% CI: 1.74~3.28), watching animations (OR=2.36, 95% CI: 1.75~3.18), playing video games (OR=1.67, 95% CI: 1.11~2.50), watching short videos (OR=1.97, 95% CI: 1.52~2.56), screen use during meals (OR=2.53, 95% CI: 1.64~3.90), caregivers permitting use due to work-related reasons (OR=1.86, 95% CI: 1.40~2.49), and caregiver home screen time > 2h (OR=1.57, 95% CI: 1.24~1.98) (P < 0.05). Conclusion Screen device usage among children aged 3~6 years is characterized by early onset and entertainment-driven motives, alongside weak self-regulation. Home environment, caregiver behaviors, device ownership, and content types are critical determinants. Multi-dimensional interventions involving families and society are warranted to facilitate the development of healthy screen habits in early childhood.
References
[1] World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva: World Health Organization; 2019.
[2] Hutton JS, Dudley J, Horowitz-Kraus T, et al.. Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children. JAMA Pediatr. 2020;174(1):e193869. doi:10.1001/jamapediatrics.2019.3869
[3] Madigan S, Browne D, Racine N, et al. Association Between Screen Time and Children's Performance on a Developmental Screening Test. JAMA Pediatr. 2019;173(3):244-250. doi:10.1001/jamapediatrics.2018.5056
[4] Li C, Cheng G, Sha T, et al. The Relationships between Screen Use and Health Indicators among Infants, Toddlers, and Preschoolers: A Meta-Analysis and Systematic Review. Int J Environ Res Public Health. 2020;17(19):7324. doi:10.3390/ijerph17197324
[5] Saunders TJ, Vallance JK. Screen Time and Health Indicators Among Children and Youth: Current Evidence, Limitations and Future Directions. Appl Health Econ Health Policy. 2017;15(3):323-331. doi:10.1007/s40258-016-0289-3
[6] Lauricella AR, Wartella E, Rideout VJ. Young children's screen time: The complex role of parent and child factors. Journal of Applied Developmental Psychology. 2015; 36: 11-17. doi:10.1016/j.appdev.2014.12.001
[7] McArthur BA, Volkova V, Tomopoulos S, et al. Global Prevalence of Meeting Screen Time Guidelines Among Children 5 Years and Younger: A Systematic Review and Meta-analysis. JAMA Pediatr. 2022;176(4):373-383. doi:10.1001/jamapediatrics.2021.6386
[8] Gonzalez Nahm S. Grossman ER, Frost N, et al. Media and young minds: Comparing state screen media use regulationns for children under 24 months of age in early care and educa- tion to a national standard. Matern Child Health J.2018; 22(4):445-453. doi:10.1007/s10995-018-2487-0
[9] Nikken P, Schols M. How and Why Parents Guide the Media Use of Young Children. J Child Fam Stud. 2015;24(11):3423-3435. doi:10.1007/s10826-015-0144-4
[10] Tu K, Shen C, Luo Y, et al. The relationships between screen exposure, parent-child interactions and comprehension in 8-month-old infants: The mediating role of shared viewing and parent-child conversation. PLoS One. 2024;19(1):e0296356. doi:10.1371/journal.pone.0296356
[11] Yu-Ting Y, Li-Xiang C, Miao Y, et al. Excessive screen time and problem behaviours among school-age children in Fujian, China: a cross-sectional study. BMC Public Health. 2025;25(1):666. doi:10.1186/s12889-025-21795-4
[12] Chung HJ, Kim H, Ma J, et al. Associations between 24-hour movement guidelines and health-related quality of life among urban preschool children in Singapore, Japan, and China. Health Qual Life Outcomes. 2025;23(1):75. doi:10.1186/s12955-025-02408-5
[13] Teng Xiaoyu, Ding Lei, Shao Jing, et al. Research on the current status and influencing factors of electronic screen exposure in children aged 4 to 6 years in Shandong. Chin J Child Health Care. 2019;27(12):1300–1303.
[14] Bandura A. Social Foundations of Thought and Action. Prentice-Hall. 1986.
[15] Radesky J, Miller AL, Rosenblum KL, et al. Maternal mobile device use during a structured parent-child interaction task. Acad Pediatr. 2015;15(2):238-244. doi:10.1016/j.acap.2014.10.001
[16] Muppalla SK, Vuppalapati S, Reddy Pulliahgaru A, et al. Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management. Cureus. 2023;15(6):e40608. doi:10.7759/cureus.40608
[17] Lutz MR, Orr CJ, Shonna Yin H, et al. Television Time, Especially During Meals, Is Associated With Less Healthy Dietary Practices in Toddlers. Acad Pediatr. 2024;24(5):741-747. doi:10.1016/j.acap.2023.09.019
[18] Hayes N, White SLJ, Berthelsen D, et al. Longitudinal associations between child, parenting, home and neighbourhood factors and children's screen time through 4 to 7 years of age. BMC Public Health. 2025;25(1):1623. doi:10.1186/s12889-025-22866-2
[19] He J, Zhong Y, Song Y, et al. The impact of only-child status on adolescent mental health: a multi-center cross-sectional study using propensity score matching in Western China. BMC Public Health. 2025;25(1):2140. doi:10.1186/s12889-025-23383-y
[20] Cao Y, Huang L, Si T, et al. The role of only-child status in the psychological impact of COVID-19 on mental health of Chinese adolescents. J Affect Disord. 2021;282:316-321. doi:10.1016/j.jad.2020.12.113

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Journal of Public Health and Preventive Medicine