Abstract
BACKGROUND: Children's decreasing outdoor time and increasing screen time (ST) raise concern, as both can impact children's health unfavourably. However, little is known about the association between young children's context-specific outdoor time and ST. This study investigated the associations between parent-child outdoor visit frequency in nature, own yard, playground, and in total and preschoolers' ST on weekdays and weekends. METHODS: Data were collected via a survey assessing parent-child outdoor visits and a 7-day ST diary completed by parents of children (n = 673, 3-6 years) participating in the DAGIS intervention study in Finland. The cross-sectional associations were examined by linear regression analyses adjusted for child age, sex, socioeconomic factors, and season. RESULTS: More frequent parent-child visits to own yard (B -1.98, 95%CI -3.43, -0.52) and nature (B -2.31, 95%CI -4.01, -0.60) were associated with less weekday ST among children, whereas more frequent visits to playground (B -3.68, 95%CI -7.18, -0.18) were associated with less weekend ST. Also, more frequent visits to nature (B -2.28, 95%CI -4.20, -0.38), own yard (B -2.38, 95%CI -4.03, -0.73), and playground (B -2.48, 95%CI -4.71, -0.25) were associated with less whole-week ST. More frequent total outdoor visits were associated with less weekday (B -1.547, 95%CI -2.38, -0.71), weekend (B -1.91, 95%CI -3.38, -0.45), and whole-week ST (B -1.77, 95%CI -2.71, -0.84). CONCLUSION: In conclusion, visiting different outdoor spaces was associated differentially with children's ST on weekdays and weekend days, whereas total outdoor visit frequency was associated with less ST throughout the week. Hence, municipalities should ensure the availability of different types of safe outdoor spaces in neighbourhoods to provide alternatives for young children's screen use. TRIAL REGISTRATION NUMBER: ISRCTN57165350, Registration date 08/01/2015.