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Lifestyle habits associated with screen time among pupils in Japan. BACKGROUND: Media use is pervasive among pupils. This study aimed to determine lifestyle factors associated with screen time. METHODS: The study used a cross-sectional design, and 2,722 questionnaires obtained from pupils in grades 5-12 were analyzed. Multiple regression analysis was used to determine significant lifestyle factors associated with screen time. Grade, gender, bedtime and waking time on both school days and non-school days, academic performance, sleepiness, breakfast, dinner regularity, defecation habits, hours of after-school activities, physical activity, and body mass index were used as the variables. RESULTS: Significant regression formulae were obtained for all school types: adjusted R2 /P values were 0.21/<0.001 for elementary school, 0.21/<0.001 for junior high school, and 0.14/<0.001 for high school. Later non-school-day bedtime (standardized regression coefficient/P values were 0.14/< 0.001 for elementary school, 0.14/<0.001 for junior high school, and 0.09/<0.05 for high school) was significantly associated with increased screen time for all school types. In both elementary and junior high schools, more sleepiness (0.12/<0.001 for elementary school, 0.13/<0.001 for junior high school), shorter after-school activity (-0.24/<0.001 for elementary school, -0.19/<0.001 for junior high school), and higher standardized body mass index (0.08/<0.05 for elementary school, 0.08/<0.01 for junior high school) were significantly associated with screen time increase. In both junior and senior high schools, breakfast skipping (0.15/<0.001 for junior school, 0.14/<0.001 for high school) revealed a significant association with screen time increase. CONCLUSIONS: Media use is associated with variable lifestyle habits. Effective approaches to reduce heavy media use remain to be determined.