Knowledge of Screen Time Recommendations among Women, Infants, and Children (WIC) Clients and Caregivers

Childhood obesity has become a national epidemic. There has been a rapid rise in childhood overweight and obesity in the United States over the last fifty years, with tripling numbers since the 1980s. Various behaviors increase risk for childhood obesity, including overuse of screen time. Obesity is associated with screen time use for the following reasons: decreased physical activity, increased sedentary activity, exposure to food advertising, and irregular patterns of eating. In response, the American Academy of Pediatrics [AAP] (1999) recommends limits on daily screen time use. AAP recommendations are as follows: children ages 0-2 should have no media use; children at and above 2 years may use 1-2 hours of media daily.

Screen time greater than AAP (1999) recommendations is an independent risk factor for obesity. The American child spends more time in front of a screen than any other daytime activity. Screen time overuse in the young child (0-5 years) is related to a greater risk for future screen time overuse and obesity. Certain familial characteristics—parental education level and income—contribute to a child’s risk for overuse of screen time. Excess screen time use is commonly noted in children of clients using Women, Infant and Children [WIC] services; this is population at high risk for screen time overuse and childhood obesity (Proctor et al., 2003). The purpose of this research is to describe WIC caregiver awareness of AAP recommendations.

This exploratory, descriptive study was conducted at a metropolitan WIC office. Parents utilizing WIC services completed a multiple-choice survey (n=36) concerning their knowledge of professional recommendations about screen time use. Participants were provided with “Screen Time Reduction: Family Fact Sheet” regarding AAP (1999) recommendations with permission from Michigan Department of Community Health upon completing the survey. Results suggest the majority of parents using WIC services are unaware of the AAP recommendations. Only 22.2% of WIC clients responded correctly regarding recommendations for children under 2 years old. Fewer participants (11.1%, n=4) correctly identified professional recommendations for children two years and greater. No parents correctly identified recommendations for both age ranges.

Prochaska’s Transtheoretical Model of Behavior Change (TTM) explains that tailoring an intervention to an individual or population’s knowledge and motivation level results in the most successful behavior change. Based on the TTM framework, the best intervention to address the WIC population’s lack of knowledge is education. The health care provider can play a pivotal role by educating high-risk clients to increase compliance with AAP recommendations.  Findings can also guide future research to identify the most effective educational interventions to address this lack of knowledge among WIC parents and caregivers.