Recreational screen time activities (e.g., computer use, television viewing, and videogame engagement) have become increasingly embedded in modern day culture, posing both physical and psychological health consequences (Babic et al., 2017; Goldfield et al., 2013). Despite the established link between recreational screen time and adolescent depressive symptomatology, little is known about mechanisms that may explain or influence this relationship. The overarching objective of the present dissertation, which includes two separate studies, was to examine cognitive, behavioural, affective, and interpersonal factors associated with the relationship between adolescents’ total daily recreational screen time activities and depressive symptomatology over time. The dissertation includes archival data from the Research on Eating and Adolescent Lifestyle (REAL) Study, which examined a large sample of students from the National Capital Region of Canada. Both Study 1 and Study 2 examined a subsample of these students. Given that exposure to screen time occupies up to 10 hours of Canadian children and adolescents’ waking hours (Active Healthy Kids Canada, 2013; Leatherdale & Ahmed, 2011; Leatherdale & Harvey, 2015), the independent variable examined in the model was total daily recreational screen time activities. Because trajectories of depressive symptomatology typically increase during adolescence (Duchesne & Ratelle, 2014), the dependent variable examined in the model was depressive symptomatology. The time points spanned over 7 years. The purpose of Study 1 was to test a prospective longitudinal path analysis model. The model examined the relationship between total daily recreational screen time at baseline (T0) and depressive symptomatology at Time 4 (T4), with body image and disordered eating behaviours at Time 2 (T2) as potential mediating variables. The final sample included 304 English-speaking students (194 females, Mage = 13.40 years, SD = 1.10). Total daily recreational screen time at T0 was significantly predictive of depressive symptomatology at T4. Appearance (dis)satisfaction at T2 mediated the relationship between total daily recreational screen time at T0 and depressive symptomatology at T4. Total daily recreational screen time at T0 was significantly predictive of emotional eating and decreased body image satisfaction at T2. Restrained eating and appearance satisfaction were negatively associated with depressive symptomatology at T4. Results were independent of age and depressive symptomatology at T0. The purpose of Study 2 was to test a longitudinal moderation model including total daily recreational screen time at T0 and depressive symptomatology at T4, with attachment style, coping style, and perceived social support at T0 as potential moderating variables. The final sample included 170 English-speaking students (106 females; Mage = 13.01, SD = 0.96). Contrary to expectation, attachment style, coping style, and perceived social support did not moderate the relationship between total daily recreational screen time at T0 and depressive symptomatology at T4. However, insecure attachment was identified as a risk factor for depressive symptomatology among males. A trend emerged in that avoidance-oriented coping appeared to be a risk factor for depressive symptomatology among females and a protective factor for males. There was also a three-way interaction between total daily recreational screen time, gender, and perceived social support. That is, when perceived social support was high, higher levels of total daily recreational screen time at T0 was associated with higher levels of depressive symptomatology at T4 for both males and females, but the relationship was significant for males only. Findings from the present dissertation offer important theoretical, methodological, and clinical implications.

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Background: The prevalence of childhood overweight and obesity is increasing worldwide. One main determinant of overweight and obesity is inactivity. Little is known about the factors that influence physical activity and sedentary behaviour among young children. Seasonal variation was examined as a correlate of physical activity in both a literature review and in a sample of pre-school children in Edmonton, Alberta. Neighbourhood socioeconomic status (SES) was examined as a correlate of screen time use in the same sample of children. Methods: For study 1, databases were searched for studies on seasonal variation in physical activity levels. Studies 2 and 3 involved a sample of 4- and 5-year-old children, who were attending a health center in and around Edmonton, Alberta for preschool immunization between November, 2005 and August, 2007. Parents provided proxy reports of their children’s screen time viewing and physical activity. Height and weight were measured by a trained health assistant and body mass index (BMI) was calculated. Children’s postal codes were retrieved from health records to calculate neighbourhood SES through census data. The month the proxy report was completed was used to determine seasonality. Several regression models were constructed to examine relationships between variables in studies 2 and 3. Results: The review of literature revealed that 83% (29/35) of the studies found seasonal variation in physical activity among children and/or adolescents. For study 2, total physical activity as well as active play, weekday and weekend minutes were highest in the summer and lowest in the winter. Finally, neighbourhood SES was a predictor of screen time and TV/video use for girls but not for boys in study 3. Conclusion: Some consideration should be given to increasing physical activity opportunities in the winter for children, especially in areas of the world that experience extreme winter conditions. As well some consideration should be given to providing alternative activity opportunities for young girls who live in lower SES neighbourhoods.

Adolescence is a period of dynamic behavioural and emotional development that can increase young people's vulnerability to mental health problems. With 70% of mental disorders having their onset during childhood or adolescence, identifying modifiable factors of these disorders among adolescents can help inform future interventions aiming to improve mental health. One of these factors is electronic technology which has become pervasive in our modern society, occupying an important portion of young people's days and changing their lifestyle. This has created serious concerns regarding the impact of heavy recreational screen use on adolescents' health, especially with the vast majority exceeding the sedentary recreational screen time recommendations of 2 hours or less per day. Evidence suggests that screen time can be associated with adolescent mental health problems. However, little is known about how the extent, nature, and types of recreational screen engagement among adolescents are associated with mental health problems as the body of evidence is very mixed, and many questions remain unanswered. Accordingly, the aims of this dissertation were: i) to summarize the evidence regarding correlates of sedentary screen pursuits among youth, ii) to examine how different types of screens, incorporating their newer forms, are associated with adolescents' mental health cross-sectionally and longitudinally, iii) to examine the nature of screen use and its association with suicidal behaviours; and iv) to explore the moderating role of sex, age, and parental support in the association between screen time and different mental health problems. To achieve these objectives, we completed four manuscripts, all prepared for submission to peer-reviewed scientific journals: 1. A narrative review on the psychological correlates of sedentary screen time behaviour among children and adolescents. 2. Heavy social media use and psychological distress among adolescents: the moderating role of sex, age, and parental support. 3. Problematic technology use, suicidal ideation, and suicide attempt among adolescents: the moderating role of sex. 4. Longitudinal associations between different types of screen use and depression and anxiety symptoms in adolescents. Collectively, our results identified that high levels of sedentary screen behaviour are associated with more severe anxiety, depressive symptoms, and suicidality among adolescents. However, the strength of associations varied between some screen types. Additionally, the findings of this dissertation indicate that a further increase in screen time is associated with increased mental health problems. Lastly, an important role of sex and age in this association was identified. These results can be used to inform future research in this field and guide future interventions designed to manage screen use among adolescents and improve their mental health.

Physical inactivity and sedentary behaviour have been independently associated with a wide range of negative health indicators including obesity, poor cardio-metabolic health, and poor psychosocial health. The overarching objective of this research was to gain a better understanding as to why children are sedentary, and where we need to focus public health messages and interventions to reduce sedentary behaviour. Specifically, I aimed to provide insight on current awareness of sedentary behaviour guidelines; determine important correlates of total sedentary time (SED), and screen time (ST) in Canadian children; and understand correlates of SED and ST in a global context. The primary dataset used for this project was the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Background work was completed to review current literature on knowledge and awareness of Canadian physical activity and sedentary behaviour guidelines (in all age groups), and to understand the representativeness of the ISCOLE dataset. In addition to the two background papers, this dissertation includes three manuscripts, all prepared for submission in scientific, peer-reviewed journals: 1. Manuscript 1: Canadian physical activity and screen time guidelines: do children know? 2. Manuscript 2: Correlates of objectively measured sedentary time and self-reported screen time in Canadian children 3. Manuscript 3: Correlates of total sedentary time and screen time in 9-11 year-old children around the world: The International Study of Childhood Obesity, Lifestyle and the Environment Overall, this work showed the majority of children around the world are accumulating large amounts of sedentary time, and exceeded current screen time guidelines. We found that the large majority of Canadian children are not aware of screen time guidelines; however, a greater proportion of children could identify physical activity guidelines. We also identified a number of correlates of SED, and ST in Canadian children, and in children around the world. The most common correlates included weight status, and access to electronics in the house. Taken together, this work suggests that public health messaging should focus on increasing awareness of screen time guidelines. While increasing awareness of the guidelines, messaging can be tailored to promoting healthy weight status, and reducing (or removing) children’s access to electronic devices in hopes of reducing overall time spent sedentary.

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The adoption of technology in our daily activities increased the time that we spend in front of the screen and changed the way we communicate and work. In recent years, many big companies started to develop and implement screen time management tools in their products to educate the user on how to improve their digital health. Those tools are an important step in the process, they bring awareness and help the users to change their habits. Several studies have focused on screen time tracking apps but not from the design perspective. Therefore, this thesis aims to explore the design of screen time management apps by developing two prototypes, which were used to evaluate different design elements and features. The results of this thesis present a guideline on how to improve the design of the existing screen time tracking tools and what additional features could be added to fulfil their aim and encourage users to change their behaviour.

AN ABSTRACT OF THE THESIS OF Cassidy Scoggins, for the Masters of Science degree in Food and Nutrition, presented on November 19, 2009, at Southern Illinois University Carbondale. TITLE: THE EFFECTS OF A COMMUNITY-BASED LIFESTYLE INTERVENTION ON SNACKING PATTERNS, SCREEN TIME PATTERNS, AND PHYSICAL ACTIVITY LEVELS AMONG ADOLESCENTS WHO ARE AT-RISK FOR TYPE 2 DIABETES MAJOR PROFESSOR: Dr. Sharon Peterson Previous research has shown that overweight and obesity in adolescents is one of the leading risk factors for developing Type 2 Diabetes Mellitus (T2DM). There are several risk factors for obesity that are modifiable in adolescents. Of these, snacking patterns, screen time, and lack of physical activity have an impact on the body weight and overall health of adolescents. The design of this "R.U.A. Healthy Kid?" study was a prospective cohort of 16 free-living adolescents at-risk for T2DM. Each participant was previously screened and found to have two or more risk factors for T2DM. The intervention targeted several components, however snacking patterns, physical activity levels and screen time levels mold the foundation for the current study. An overall "snacking score" was developed to measure the frequency and quality of snacking patterns of participants. After three months of intervention, participants' overall snacking score increased. Many significant relationships were found between the overall snack score, physical activity, and screen time questions, such as negative relationships between: "time on TV" and total snacking score and "time spent walking, biking, or jogging" and "unhealthy" snacking score. These results show how community-based lifestyle interventions that address adolescents' snacking patterns, screen time levels, and physical activity levels are crucial in the fight to overcome the T2DM epidemic now prevalent in adolescents.

Excessive screen time in children is linked to reduced white matter integrity and developmental delays such as reduced vocabulary. Nevertheless, many parents allow their infants and toddlers to have access to screen devices. The current study examined mothers’ awareness of the American Academy of Pediatrics recommendations, parenting information sources utilized, and motivational and contextual factors associated with screen time exposure in mothers who had a child under the age of two. Results indicated that over 60% of mothers were aware of the recommendations, usually citing educational benefits as their rationale for infant screen time use. Most mothers reported they receive information from medical professionals or online platforms. These findings identify factors that researchers, policy makers, and public health professionals should consider when updating and disseminating information to the public in the near future.

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