Abstract
INTRODUCTION: Associations between screen time and health outcomes among teenagers are well established. However, most studies use parent-reported information, which may misrepresent the magnitude or nature of these associations. In addition, timely nationally representative estimates are needed to correspond with evolving screen use. This study aimed to address these gaps by using data from a nationally representative survey of teenagers. METHODS: Data came from the 2021-2023 National Health Interview Survey-Teen (NHIS-Teen), a follow-back web-based survey designed to collect health information directly from teenagers aged 12 to 17 years. NHIS-Teen provides a unique opportunity to assess teenagers' self-reported health in conjunction with a rich set of parent-reported covariates, including family income, from the National Health Interview Survey. This study examines associations between high daily non-schoolwork screen time, defined as 4 or more hours of daily screen time, and adverse health outcomes across the domains of physical activity, sleep, weight, mental health, and perceived support. RESULTS: Teenagers with higher non-schoolwork screen use were more likely to experience a series of adverse health outcomes, including infrequent physical activity, infrequent strength training, being infrequently well-rested, having an irregular sleep routine, weight concerns, depression symptoms, anxiety symptoms, infrequent social and emotional support, and insufficient peer support. CONCLUSION: Results of this study include associations between high screen time and poor health among teenagers using self-reported data. Future work may further investigate these associations and their underlying mechanisms, including the content viewed on screens and the interactions taking place across screens.