European Journal of Cardiovascular Medicine

The prevalence of excessive screen time among adolescents has become a significant public health concern in recent years, particularly in developing countries like India. As digital devices become increasingly accessible, even in rural areas, understanding the extent of screen time exposure and its potential impacts on adolescent health and development is crucial.

This cross-sectional study aims to investigate the prevalence of screen time among adolescent school children in rural Telangana, India. The research is particularly timely and relevant, as previous studies have shown varying rates of excessive screen time among adolescents in different parts of India. For instance, a study conducted in Karnataka reported a mean total screen time of 93 minutes for rural high school students¹. Another study in rural western India found that more than 80% of children exceeded the recommended screen time¹.

The American Academy of Pediatrics recommends limiting screen time to no more than two hours per day for children and adolescents². However, adherence to these guidelines may be challenging in the current digital age, especially in the wake of the COVID-19 pandemic, which has led to increased reliance on digital devices for education and entertainment.

By focusing on rural Telangana, this study aims to provide valuable insights into the screen time habits of adolescents in a specific regional context. The findings will contribute to the growing body of literature on screen time prevalence in India and may inform targeted interventions to promote healthier screen use habits among rural adolescents.

Aims and objectives:

Aim: To determine the prevalence of screen time among adolescent school children in rural Telangana, India.

Primary Objective:

1. The prevalence of screen time among adolescent school children in rural Telangana, India.

Secondary Objectives:

2. To assess the distribution of screen time duration among the study population
3. To analyze the relationship between screen time and demographic factors such as age, class, and socioeconomic status.
4. To identify the proportion of adolescents exceeding the recommended screen time of two hours per day.

The Cross-Sectional Study was performed between June 2023 and August 2023 for a period of 3 months at the Department of Pediatrics, CMR Institute of Medical Sciences, Hyderabad, India focusing on the field practice area of Dabilpur village. The study employed a structured proforma for systematic data collection

The sample size was selected using quota sampling technique, 200 subjects in 2 out of 8 schools which were selected by simple randamisation and 100 adolescent students from each school were chosen by using systematic sampling technique.

The statistical analysis employed standard statistical formulas to process and interpret the collected data. All statistical analysis is performed in SPSS (statistical package for social sciences) version 23, Microsoft Word and Microsoft Excel software.

Ethical Considerations:

• Ethical approval was obtained from the institutional ethics committee prior to the study commencement.
• Informed consent was obtained from all participants and their guardians.
• Confidentiality of the collected data was maintained throughout the study

Table 1 :Age Distribution

Table 2: Class Distribution

Socioeconomic Distribution (B.G. Prasad Scale)

Table 3 : Average Screen Time Distribution :

The cross-sectional study conducted in rural Telangana, India, provides valuable insights into the prevalence of screen time among adolescent school children. The study sample consisted of 200 participants, with the majority aged between 13 and 15 years. Most students were from 8th and 9th grades, accounting for 75.5% of the total participants. The family structure analysis revealed that 62.5% of the participants belonged to joint families, while 28.5% came from nuclear families.

Socioeconomic status, assessed using the B.G. Prasad Scale, showed a diverse distribution across social classes. The largest group (34%) fell into Class III (Middle), followed by Class IV (Lower Middle) at 22.5% and Class II (Upper Middle) at 21%. This distribution provides context for understanding the screen time habits in relation to socioeconomic factors.

The key finding of the study is the prevalence of screen time exceeding 2 hours per day, which was found to be 13.5%. This figure is particularly significant as it surpasses the American Academy of Pediatrics' recommendation of limiting screen time to no more than two hours per day for children and adolescents. The majority of participants (86.5%) reported screen time of 2 hours or less per day, while 11% reported 3-4 hours, and 2.5% reported 5 hours of daily screen time.

The findings of this cross-sectional study on screen time prevalence among adolescent school children in rural Telangana, India, provide valuable insights into the current digital habits of this population. The study revealed that 13.5% of the participants exceeded the recommended screen time of two hours per day, which is lower than the prevalence reported in some recent studies but still a cause for concern.

Comparing our results to recent literature, we find both similarities and differences in screen time prevalence across various regions in India. A study conducted in rural western India among pre-schoolers showed that more than 80% of children exceeded the recommended screen time¹. This stark difference in prevalence could be attributed to the younger age group studied and potentially different socioeconomic factors in that region.

Another study in rural North India reported a prevalence of 61.8% for excess screen time¹. The lower prevalence in our study (13.5%) might be due to differences in urbanization levels, access to digital devices, or regional variations in lifestyle and parental supervision.

Interestingly, a study by Pooja et al. (2021) in a rural school on children aged 10-19 years found only 17% of students spending excess screen time⁴, which is more closely aligned with our findings. Jamir L, et al. (2019):The study found that 30.3% (95% Confidence Interval = 27.2%-33.3%) of school students in rural India met the criteria for technology addiction⁵. This similarity suggests that rural areas may still have lower rates of excessive screen time compared to urban settings.

However, our results contrast sharply with a study conducted in secondary schools in rural Pune, India, which reported a prevalence of 83.2% for excess screen time¹. This significant difference could be due to the study being conducted during the COVID-19 pandemic, which likely increased screen time due to online classes and limited outdoor activities.

The lower prevalence in our study compared to some others might be attributed to several factors:

1. Limited access to digital devices in rural Telangana
2. Stronger parental controls or cultural norms limiting screen time
3. Higher engagement in outdoor activities or household chores
4. Potential underreporting by participants

It's important to note that our study found mobile phones to be the most commonly used device, which aligns with the findings from the Pune study¹. This trend highlights the increasing accessibility of smartphones even in rural areas and underscores the need for targeted interventions focusing on mobile device usage.

While our prevalence is lower than some recent studies, it still indicates that a significant portion of adolescents in rural Telangana are exceeding recommended screen time limits. This finding emphasizes the need for continued awareness, education, and interventions to promote healthy screen habits among rural adolescents.

Future research should explore the factors contributing to the relatively lower prevalence in this region and investigate whether these protective factors can be leveraged in other areas to reduce excessive screen time among adolescents.

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