The Family Level Assessment of Screen Use-mobile approach: Development of an approach to measure children's mobile device use

Authors: PEREZ, ORIANA - Children'S Nutrition Research Center (CNRC); KUMAR VADATHYA, ANIL - Rice University; BELTRAN, ALICIA - Children'S Nutrition Research Center (CNRC); BARNETT, R - Rice University; HINDERA, OLIVIA - Baylor College Of Medicine; GARZA, TATYANA - Children'S Nutrition Research Center (CNRC); MUSAAD, SALMA - Children'S Nutrition Research Center (CNRC); BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC); HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC); MENDOZA, JASON - Fred Hutchinson Cancer Research Center; SABHARWAL, ASHUTOSH - Rice University; VEERARAGHAVAN, ASHOK - Rice University; O'CONNOR, TERESIA - Children'S Nutrition Research Center (CNRC)

Submitted to: JMIR Formative Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/15/2022
Publication Date: 10/21/2022
Citation: Perez, O., Kumar Vadathya, A., Beltran, A., Barnett, R.M., Hindera, O., Garza, T., Musaad, S.M., Baranowski, T., Hughes, S.O., Mendoza, J.A., Sabharwal, A., Veeraraghavan, A., O'Connor, T.M. 2022. The Family Level Assessment of Screen Use-mobile approach: Development of an approach to measure children's mobile device use. JMIR Formative Research. 6(10). Article e40452. https://doi.org/10.2196/40452.
DOI: https://doi.org/10.2196/40452

Interpretive Summary: There is growing interest among scientists to directly measure young children's screen media use to better understand its impact on children's growth, metabolic health, development and mental health outcomes. Apps have been developed for mobile devices to track the use of that device and which apps were used and for how long. However these tracking apps pose problems when used to measure younger children's mobile device use because children often share a device with other family members. Approaches are needed to differentiate the child's use of the device from other family member's use of that device. In this pilot study, we tested an approach called Family Level Assessment of Screen Use (FLASH)-Mobile to measure young children's mobile device use directly with (1) an app to track device and app use logging, (2) notifications to identify the user of the device, (3) a system to provide feedback on compliance with the user identification notification to improve compliance, and (4) a minimum threshold of user identification to be included in the analysis. Several versions of the approach were iteratively tested in 2 laboratory-based observational feasibility studies and 2 home-based feasibility studies in the United States among children 6- 11 years of age. The lab observation studies consisted of a standardized series of tasks while using the mobile device or watching television, which were video recorded. The video recordings were coded by staff to be compared to the device use tracked by the mobile app. The final version of the FLASH-mobile approach resulted in user identification compliance rates of >90% for smartphones and >80% for tablets. For laboratory-based studies, a mean agreement of 73.6% (SD 16.15%) was found by the tracking app and the coded video observations. The FLASH-mobile approach offers an important new research approach to measure children's use of mobile devices more accurately across several days, even when the child shares the device with other family members.

Technical Abstract: The objective of this study was to assess the feasibility of measuring the screen time of children on mobile devices using the Family Level Assessment of Screen Use (FLASH)-mobile approach, an innovative method that leverages the existing features of the Android platform. This pilot study consisted of 2 laboratory-based observational feasibility studies and 2 home-based feasibility studies in the United States. A total of 48 parent-child dyads consisting of a parent and child aged 6 to 11 years participated in the pilot study. The children had to have their own or shared Android device. The laboratory-based studies included a standardized series of tasks while using the mobile device or watching television, which were video recorded. Video recordings were coded by staff for a gold standard comparison. The home-based studies instructed the parent-child dyads to use their mobile device as they typically use it over 3 days. Parents received a copy of the use logs at the end of the study and completed an exit interview in which they were asked to review their logs and share their perceptions and suggestions for the improvement of the FLASH-mobile approach. The final version of the FLASH-mobile approach resulted in user identification compliance rates of >90% for smartphones and >80% for tablets. For laboratory-based studies, a mean agreement of 73.6% (SD 16.15%) was achieved compared with the gold standard (human coding of video recordings) in capturing the target child's mobile use. Qualitative feedback from parents and children revealed that parents found the FLASH-mobile approach useful for tracking how much time their child spends using the mobile device as well as tracking the apps they used. Some parents revealed concerns over privacy and provided suggestions for improving the FLASH-mobile approach. The FLASH-mobile approach offers an important new research approach to measure children's use of mobile devices more accurately across several days, even when the child shares the device with other family members. With additional enhancement and validation studies, this approach can significantly advance the measurement of mobile device use among young children.